Late Breaking Poster Session Group III – Green LB TPS 2

Abstract

Background: Diagnosis and management of allergic patients are often performed exclusively by general practitioners (GPs). Because of the increasing prevalence of allergic diseases and because of the limited knowledge of GPs on allergy, an allergy management support system (AMSS) was developed. The aim of this study was to test the feasibility of an AMSS for primary care in a pilot study. Method: Using a randomized controlled design, GPs in the intervention group received AMSS advice in addition to sIgE test results and GPs in the control group performed usual care based on sIgE test results only. The AMSS advice was based on the AMSS history questionnaire completed by patients and sIgE test results. The AMSS advice included probable diagnoses and recommendations for management. AMSS advice was also formulated for patients in the control group for evaluative purposes only. Patients were included by GPs when ordering an sIgE test. GPs in both groups completed a short questionnaire on diagnosis and management at the time of inclusion (T1) and after sIgE test outcomes were known (T2). A total agreement score between GP and AMSS was calculated as the number of concordant diagnoses minus the number of false negative and false positive diagnoses. The AMSS was considered feasible when >70% of the AMSS advice was sent to the GP within 10 workdays of sIgE testing. Results: Of the 75 GPs that agreed to participate, 27 GPs (37%) included one or more patients in the study. Together they included 101 patients of which 66 (67%) completed the AMSS history questionnaire. The majority of the AMSS advice (93%) was sent back to the GP within 10 workdays after sIgE test results were known (mean (SD) 4.7 (4.0) workdays). GPs in the intervention group reported that the AMSS advice was complete and to-the-point in 80% of cases, agreed for the most part with the AMSS advice in 80% of cases and followed the AMSS advice for the most part in 71% of cases. The difference in total agreement scores on diagnosis (T2 minus T1), was significantly higher in the intervention group than in the control group (mean (SD) 0.9 (1.8); -0.8 (1.0); P <0.001). Conclusion: Because 93% of the AMSS advice was sent to the GP within 10 workdays the AMSS may be considered feasible. In addition, a majority of the GPs reported that they completely followed the AMSS advice. This was confirmed by the greater agreement on diagnoses between GPs and AMSS in the intervention group than in GPs using usual care.