How the Allergist/Immunologist Can Help:

Consultation and Referral Guidelines Citing the Evidence

Introduction

Allergic diseases affect more than 20 percent of the U.S. population, and are the sixth leading cause of chronic disease in the United Statei. Allergic rhinitis alone leads to approximately 16.7 million office visits to health care providers each year, while asthma-related visits to the emergency department number 1.8 million each year, with another 465,000 asthma-related hospitalizationsiv. Indirect costs from asthma are reported to be more than $600 million.

Allergies and asthma cause unnecessary deaths each year: about 100 people in the United States die from food-related anaphylaxisvi, another 40 from insect sting anaphylaxis. Asthma leads to about 5,000 deaths each year.

For many of these patients, working with an allergist/immunologist can assist them in managing their disease. However, there are not enough allergist/immunologists to treat all patients who have allergic diseases. This Referral Guideline developed by the American Academy of Allergy, Asthma and Immunology is designed to assist patients and health care professionals in determining when referral to an allergist/immunologist is needed, which may be a single or limited consultation, lead to co-management between a primary care provider and an allergist/immunologist, or require ongoing specialty care by the allergist/immunologist.

Providing information based on evidence to assist patients and health care providers in the decision-making process should benefit not only the individuals but our health care system as a whole. The evidence included in this guide is based on:

• Diagnostic evidence: tests performed or interpreted by allergist/immunologists facilitate diagnosis

• Direct outcome evidence: evidence that intervention by an allergist/immunologist improves outcomes

• Indirect outcome evidence: evidence that interventions performed by allergist/immunologists improve outcomes (evidence to support established pharmacologic management will generally not be reviewed)

© 1996-2006 · All Rights Reserved · American Academy of Allergy Asthma & Immunology

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The Journal of Allergy and Clinical Immunology-Volume 117, Issue 2, Supplement S3 (February 2006)
Consultation and referral guidelines citing the evidence: How the allergist-immunologist can help-Edited by Donald Leung MD, PhD, FAAAAI, Michael Schatz MD, MS, FAAAAI (all sections in downloadable pdf format)