Outcome of Aeroallergen evaluation by skin antigen testing followed by counselling on preventive behavior in Chronic Respiratory Allergy in a tertiary care setting

Abstract

Introduction: The burden of illness from chronic allergic disorders like rhinitis(RH), asthma, and RH coexisting with asthma is usually due to recurrent exacerbations. The quality of life of such patients can be improved if we can control such exacerbations. Objective: To assess the outcome of trigger avoidance and drug adherence among chronic respiratory allergy patients who have undergone skin antigen testing followed by counselling. Materials & Methodology: Study design: Observational descriptive study. Study subjects: Chronic Respiratory Allergy patients. Sample size and sampling strategy: 102 consecutive cases of chronic respiratory allergy subjects who have undergone skin antigen testing and counselling. Inclusion and exclusion: Patients of both sexes who have undergone skin antigen testing between the age group 18 to 55 years. Those who have not given consent and those with critical illness were excluded. Outcome measure: Reduction in exacerbation and emergency room visits three months after the intervention. Intervention: Respiratory allergen skin testing followed by counselling on trigger avoidance and drug adherence. Data Collection: Patients were interviewed using a structured questionnaire before and 3 months after antigen testing followed by counseling. Results: Data from 102 cases were analyzed. The male to female ratio was 1: 1.2 with a mean age of 31years with an SD of 7 years. The most common allergen identified was indoor dust allergens. with house dust, 69.6% followed by house dust mite(HDM) 59.8%. Dual drug (preventer and reliever) inhaler therapy and administration of Leukotriene antagonists were the main drugs adhered to and 67.6 % of participants used more than 1 drug for the control of their exacerbations. The mean exacerbation rate before intervention was 4.12 and after was 1.07(p<0.01). The mean ER visit before was 0.76 and after the intervention was found to be nil (p <0.01). Conclusion: Identification of triggers by skin antigen testing and counselling related to prophylactic drug administration has resulted in better preventive and medication behavior. This has led to a reduction in exacerbations and ER visits on short-term assessment. Reduced exacerbation and ER visits may have a positive impact on the quality of life of chronic respiratory allergy patients.