Written by James Coker | Reporter, European Medical Journal | @EMJJamesCoker
With Allergy Awareness Week 2018 having recently taken place from 23rd–29th April this year, EMJ caught up with the charity Allergy UK to discuss this year’s campaign as well as a number of other pertinent topics related to the care of allergy patients. For this we spoke to two prominent Allergy UK ambassadors, Communications Manager, Ms Maggie Young, and Nurse Advisor Ms Holly Shaw who shared their insights and expertise about the work of the charity and current trends in the field.
Allergic disease is currently believed to affect 1 billion people worldwide and this figure is projected to rise to 4 billion in the 2050s.1 In addition to an urgent need to better understand the mechanisms of allergy and develop new treatments, it is vital that those living with allergy are equipped with the tools they need to manage their condition at all times. It is with this in mind that Allergy UK aim to provide help and advice to patients and healthcare professionals alike in order to ensure that patient care is optimal. Topics included in our discussion were the work the charity takes to improve knowledge and awareness of allergy and emerging areas in the field in addition to insights into Allergy Awareness Week 2018, the theme of which was ‘Travelling with Allergy’.
Travelling with Allergy
For the annual Allergy Awareness Week, the UK-based charity has a specific theme that is decided following analysis of feedback from surveys they carry out, ensuring the focus is topical and relevant to allergy patients. For example, anaphylaxis was at the heart of the 2015 awareness week. This year, Allergy UK highlighted the difficulties the food allergic traveller face whilst travelling abroad to new climates and disseminated vital information about reducing the risk of an allergy attack occurring and managing the situation if it does. “The theme really was the fear of the unknown and accidental exposure when you’re taken out of your own environment that you’re used to managing your allergy in, whether that be at home or at school, and then you’re taken to somewhere else; that kind of underlying fear people have,” explained Ms Shaw. “They’re not quite sure what they should do or what would happen if they accidently come into contact with something they are allergic to.”
Translation Cards
To help with this issue, Allergy UK provides a translation card service. Printed in the language of the country or region they are visiting, the cards include an alert message, an emergency message, and clear instructions for when going to restaurants to ensure that food orders do not contain the particular food allergen that causes a reaction.2
Allergy Plan
The charity also strongly advocates the creation of a detailed allergy action plan for allergy patients to take with them on their travels, with information including signs and symptoms and the medications needed and when they should be taken. “We do reinforce that patients need written information,” elucidated Ms Shaw. “Only a small amount of a conversation that happens between a healthcare professional and a patient is remembered, especially considering the depth of these conversations for those that are newly diagnosed or are children, so any information that can be captured in a written form is really useful.”
Training for Doctors
Ms Shaw explained how, in the context of increasing numbers of allergy cases, Allergy UK has a role in educating and raising awareness of the condition for professionals working in primary care. Typically, primary care physicians receive limited training in this area of medicine and Allergy UK helps to rectify any gaps in expertise. “The GPs are seeing these patients on a day-to-day basis, so they’re very keen to engage with us, to take opportunities to increase their knowledge of allergic disease, and we focus on key areas as the allergy landscape changes in regard to current allergy trends,” she said.
Masterclasses
In addition to information compiled by experts in the field, the charity organises annual Masterclasses for healthcare professionals. This years’ free-to-attend event is titled ‘Demystifying Paediatric Allergy’, a topic chosen due to the high percentage of calls received by Allergy UK from parents concerned about possible allergy symptoms in their children. The aim is for GPs and other health professionals working in primary care to have the knowledge to provide the best possible advice during consultations to help address this growing concern. “We’ll be touching on all the disciplines of allergy that GPs see on a day-to-day basis, equipping them with the best practice and advice, signposting them on where they can get their hands on that during their very short consultation, and we’ll have a line-up of top professionals in those areas to deliver that information,” explained Ms Shaw.
Cow’s Milk Allergy
Another major focus recently has also been on cow’s milk allergy (CMA) in the paediatric population as this is an increasingly growing area and one in which GPs often have limited understanding of; Ms Shaw believes the help given in this respect has made a big difference to parents worried about their baby’s allergic reaction to CMA. Likewise, the 2017 updated version to the iMAP guidelines on CMA3 has anecdotally appeared to have a positive effect for the advice and support GPs give to their patients. This sort of education and knowledge for primary care physicians, as well as improving the care for patients, helps ensure enhanced cost-effectiveness for health systems, something that is vitally important in an age of increasing financial pressures. “If it can be managed through the GP it obviously has a whole benefit to the patient as well as the healthcare system,” she added.
Information for Patients
In addition to their work with healthcare professionals, one of major focusses of Allergy UK remains on providing information to the growing number of people living with allergy. They estimate there are 21 million allergy sufferers in the UK currently, and an increasing number of children affected by allergies. This means a lot of information is required amongst the general population and Ms Young commented there had been around 80,000 visitors to their website in March, emphasising the interest there is. The charity therefore provides a huge amount of free fact sheets written by experts in the field, with well over 8,000 downloaded in the month of March. “I think it demonstrates a need for information, for help and support, and our helpline also feeds back all the information they gather,” said Ms Young. “So a lot of what we do is influenced by the kind of questions, the information that people want so we can identify if there is a need for specific information about a particular allergy. We’re able to be quite responsive in that respect, looking at that particular issue and examining what we can do with it.”
Collaboration
The charity also collaborates with a number of important organisations in the field including the European Academy of Allergy and Clinical Immunology (EAACI) and the British Society of Allergy and Clinical Immunology (BSACI) to ensure that information is disseminated to the widest audience possible. They also work closely with the UK Food Standards Agency (FSA), who quickly inform them of issues suddenly occurring in food, for example contamination, that needs to be communicated immediately to allergy patients, which Allergy UK can do through alerts to their members.
Emerging Areas
We also discussed areas that are becoming more prominent in allergy and attracting much attention. One of these is food allergy in children, an issue that parents commonly call the Allergy UK helpline to discuss. Ms Shaw expressed her belief that the nature of modern lifestyles is a major contributor to this, such as the way children are fed and lack of exposure to a diverse range of microbes due to staying indoors more often than in previous generations. This may partially explain the huge rise in food allergy cases in the Western world, particularly over recent years.4
Late-Onset Allergy
Another is late-onset allergy, whereby development of allergies is increasingly occurring in people in adulthood, which was previously a rare phenomenon. This is certainly an area researchers are trying to better understand the mechanisms of. “There is definitely a Nobel prize for the scientists that work out what turns that allergy switch off and on and understand why adults are suddenly developing allergy when we know children and infants follow a certain pattern of allergic disease,” commented Ms Shaw.
It is possible the increased prevalence of late-onset allergies is linked to indoor air quality, which is an area Allergy UK are taking a substantial interest in regarding its possible impact on allergies. This includes the construction of housing and the conditions of certain work environments, again areas attracting significant research interest.
Growing Area in Medicine
Allergy is a rapidly growing problem, and in many cases can have a very detrimental impact on people’s lives. Awareness and appreciation is increasing, however, and Allergy UK is one of the organisations who are providing much needed help and information to patients, as well as helping plug the knowledge gap that many healthcare professionals have, particularly in primary care. Aspects related to modern life appear to be driving up the numbers, although a lot more research needs to be undertaken to fully understand the exact mechanisms behind these causes and the development of new treatments.
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REFERENCES
- EAACI. Global Atlas of Allergy. 2014. Available at: http://www.eaaci.org/GlobalAtlas/GlobalAtlasAllergy.pdf. Last accessed: 19 April 2018.
- Allergy UK. Translation Cards. Available at: https://www.allergyuk.org/get-help/translation-cards. Last accessed: 19 April 2018.
- Allergy UK. iMAP Guideline. Available at: https://www.allergyuk.org/health-professionals/mapguideline#anchor1. Last accessed: 19 April 2018.
- EAACI. Food Allergy & Anaphylaxis Public Declaration. Available at: http://www.eaaci.org/attachments/FoodAllergy&AnaphylaxisPublicDeclarationCombined.pdf. Last accessed: 19 April 2018.
To access the Allergy UK website, click here.