TY - JOUR
T1 - Management of chronic spontaneous urticaria
T2 - A worldwide perspective
AU - Kolkhir, Pavel
AU - Pogorelov, Dmitry
AU - Darlenski, Razvigor
AU - Caminati, Marco
AU - Tanno, Luciana Kase
AU - Le Pham, Duy
AU - Gonzalez-Estrada, Alexei
AU - Antolín-Amérigo, Darío
AU - Dimov, Ves
AU - Weller, Karsten
AU - Sánchez-Borges, Mario
AU - Ansotegui, Ignacio
AU - Maurer, Marcus
N1 - Funding Information:
The study was supported by WAO (the dissemination of the questionnaire via WAO online resources, the hosting of the questionnaire and data and funding the authors’ APC fees to the publisher of the WAO Journal).
Publisher Copyright:
© 2018 The Author(s).
PY - 2018/7/4
Y1 - 2018/7/4
N2 - Background: The approaches to the diagnosis and treatment of chronic spontaneous urticaria (CSU) differ in various parts of the world. We sought to determine the adherence to international and national urticaria guidelines as well as the motives to deviate from the guidelines among physicians worldwide. Methods: A web-based questionnaire was created and launched via e-mail by the World Allergy Organization (WAO) to representatives of all WAO Member Societies, the members of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the members of the WAO Junior Members Group (JMG), regardless of the specialty, affiliation, or nationality in March 2017. Results: We received 1140 completed surveys from participating physicians from 99 countries. Virtually all participants (96%) were aware of at least one urticaria guideline and reported that they follow a guideline. However, one in five physicians who follow a guideline (22%) reported to deviate from it. Reliance on own clinical experience is the most frequent reason for deviation from guidelines or not following them (44%). Young (< 40 years) and less experienced physicians more often follow a guideline and less often deviate than older and experienced ones. Physicians who follow a urticaria guideline showed higher rates of routinely ordering a complete blood count, the erythrocyte sedimentation rate, C-reactive protein, anti-thyroid antibodies, and thyroid-stimulating hormone and of performing the autologous serum skin test as compared to those who do not. Physicians who follow a urticaria guideline showed higher rates of using second generation antihistamines as their first-line treatment of CSU (p = 0.001) and more frequently observed higher efficacy of these drugs (or had more confidence that it would work, p < 0.019) as compared to those who do not follow the guidelines. Conclusions: Physicians' characteristics (e.g. age, clinical experience, and specialty) and country specifics and regional features (e.g. availability of drugs for CSU treatment) importantly influence adherence to urticaria guidelines and CSU patient care and should be addressed in more detail in future research.
AB - Background: The approaches to the diagnosis and treatment of chronic spontaneous urticaria (CSU) differ in various parts of the world. We sought to determine the adherence to international and national urticaria guidelines as well as the motives to deviate from the guidelines among physicians worldwide. Methods: A web-based questionnaire was created and launched via e-mail by the World Allergy Organization (WAO) to representatives of all WAO Member Societies, the members of the American Academy of Allergy, Asthma & Immunology (AAAAI) and the members of the WAO Junior Members Group (JMG), regardless of the specialty, affiliation, or nationality in March 2017. Results: We received 1140 completed surveys from participating physicians from 99 countries. Virtually all participants (96%) were aware of at least one urticaria guideline and reported that they follow a guideline. However, one in five physicians who follow a guideline (22%) reported to deviate from it. Reliance on own clinical experience is the most frequent reason for deviation from guidelines or not following them (44%). Young (< 40 years) and less experienced physicians more often follow a guideline and less often deviate than older and experienced ones. Physicians who follow a urticaria guideline showed higher rates of routinely ordering a complete blood count, the erythrocyte sedimentation rate, C-reactive protein, anti-thyroid antibodies, and thyroid-stimulating hormone and of performing the autologous serum skin test as compared to those who do not. Physicians who follow a urticaria guideline showed higher rates of using second generation antihistamines as their first-line treatment of CSU (p = 0.001) and more frequently observed higher efficacy of these drugs (or had more confidence that it would work, p < 0.019) as compared to those who do not follow the guidelines. Conclusions: Physicians' characteristics (e.g. age, clinical experience, and specialty) and country specifics and regional features (e.g. availability of drugs for CSU treatment) importantly influence adherence to urticaria guidelines and CSU patient care and should be addressed in more detail in future research.
KW - Chronic spontaneous urticaria
KW - Global survey
KW - Guideline adherence
KW - Guidelines
KW - Urticaria management
KW - Urticaria treatment
KW - Worldwide
UR - http://www.scopus.com/inward/record.url?scp=85049438767&partnerID=8YFLogxK
U2 - 10.1186/s40413-018-0193-4
DO - 10.1186/s40413-018-0193-4
M3 - Article
AN - SCOPUS:85049438767
SN - 1939-4551
VL - 11
JO - World Allergy Organization Journal
JF - World Allergy Organization Journal
IS - 1
M1 - 193
ER -