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      Characteristics of patients receiving allergy vaccination: to which extent do socio-economic factors play a role?

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          Abstract

          Background: Little is known about characteristics of patients receiving allergen-specific immunotherapy. Identifying obstacles to appropriate treatment according to guidelines may facilitate the development of strategies aiming at improved treatment of patients with allergic respiratory diseases. The objective of this study was to investigate differences in disease severity, demographic and socioeconomic status between allergic rhinitis patients receiving allergen-specific immunotherapy and allergic rhinitis patients not receiving allergen-specific immunotherapy. Methods: A total of 366 patients were studied of whom 210 were going to receive subcutaneously administrated immunotherapy (SIT) against grass pollen and/or house dust mite allergy. The severity of rhino-conjunctivitis (hay fever) and/or asthma was classified according to international guidelines. The questionnaires included an EQ-5D visual analogue scale instrument and some socio-economic questions. Results: Severity of disease, young age, high level of education as well as greater perceived impairment of health-related quality of life due to allergic symptoms were significantly associated with use of SIT. Somewhat unexpectedly, household income was not associated with use of SIT. Conclusion: Use of SIT was associated with both disease severity measures and educational level, but not income level. These results suggest social inequality as reflected by lower use of SIT among patients with lower educational level may represent an obstacle to treatment with SIT.

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          Most cited references28

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          Practical statistics for medical research. Douglas G. Altman, Chapman and Hall, London, 1991. No. of pages: 611. Price: £32.00

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            Prevalence and rate of diagnosis of allergic rhinitis in Europe.

            To measure the prevalence of allergic rhinitis among European adults and the proportion of undiagnosed subjects, a two-step, cross-sectional, population-based survey in Belgium, France, Germany, Italy, Spain, and the UK was undertaken. Step one of the study involved screening for allergic rhinitis by telephone interview, based on history of symptoms and/or self-awareness of the condition. Step two undertook confirmation of allergic rhinitis in a subset of the subjects screened positive; this was performed by a clinical diagnosis conducted in three to five clinical centres per country, including specific immunoglobulin E tests and a disease-specific questionnaire. A total of 9,646 telephone interviews were conducted between February and April 2001. Self-awareness of allergic rhinitis was reported by 19% of the subjects. Physician-based diagnosis of allergic rhinitis was reported by 13% of the subjects. In step two, 725 clinical assessments were conducted between May and August 2001. A total of 411 of patients, who underwent step two, had investigator-confirmed allergic rhinitis. Among patients with investigator-confirmed allergic rhinitis, 45% had not reported a previous diagnosis by a physician. Prevalence of subjects with clinically confirmable allergic rhinitis estimated by combining step one and step two data ranged from 17% in Italy to 29% in Belgium with an overall value of 23%. This large-scale study confirms that allergic rhinitis has a high prevalence in western Europe and is frequently undiagnosed.
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              Allergen immunotherapy: therapeutic vaccines for allergic diseases. A WHO position paper.

              The World Health Organization and various allergy, asthma, and immunology societies throughout the world met on January 27 through 29, 1997, in Geneva, Switzerland to write guidelines for allergen immunotherapy. Over the ensuing year, the editors and panel members reached a consensus about the information to include in the WHO position paper "Allergen immunotherapy: Therapeutic vaccines for allergic diseases." The historical term allergen extract was changed to allergen vaccine to reflect the fact that allergen vaccines are used in medicine as immune modifiers. The document summarizes the scientific literature and rationale for the appropriate use of such therapy to treat allergic rhinoconjunctivitis, allergic asthma, and Hymenoptera hypersensitivity. It also includes recommendations to improve safety, discusses new techniques being developed that may result in better efficacy and less risk, and offers recommendations for areas of additional and necessary research.
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                Author and article information

                Journal
                Eur J Public Health
                eurpub
                eurpub
                The European Journal of Public Health
                Oxford University Press
                1101-1262
                1464-360X
                June 2011
                19 May 2010
                19 May 2010
                : 21
                : 3
                : 323-328
                Affiliations
                1 Institute of Public Health—Health Economics, University of Southern Denmark, Odense C, Denmark
                2 Department of Respiratory Diseases, Aarhus University Hospital, Aarhus, Denmark
                3 ALK-Abelló, Department of Research and Development, Hørsholm, Denmark
                4 Danish Institute for Health Services Research, København Ø, Denmark
                5 Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup University Hospital, Glostrup, Denmark
                Author notes
                Correspondence: Karin Dam Petersen, Department of Research and Development, MarselisborgCentret, Central Denmark Region and The Institute of Public Health, Aarhus University, P. P. Ørumsgade 11, byg. 8, DK - 8000 Århus C, Denmark, tel: +45 2228 8914, fax: +45 8949 1217, e-mail: karin.petersen@ 123456stab.rm.dk
                Article
                ckq063
                10.1093/eurpub/ckq063
                3098894
                20484343
                76704aae-13d6-4d18-a084-6f1c007647ba
                © 2010. The Author(s)

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/2.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 21 October 2009
                : 19 April 2010
                Page count
                Pages: 6
                Categories
                Vaccination

                Public health
                quality of life,immunological desensitization,hay fever,health services needs and demand,asthma

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