OBJECTIVE: To analyse the appropriateness of specific immunotherapy treatment (IT) to indications based on scientific evidence. DESIGN: Cross-sectional, descriptive study. SETTING: Primary care in a health district of about 12,000 inhabitants. PATIENTS: 166 patients for whom IT was prescribed in the period between January 1998 and June 1999 were included. The full evaluation covered 65 patients whose allergy report was available in their clinical records. MEASUREMENTS AND RESULTS: IT prescription was considered adequate in patients with single sensitivity to respiratory allergy or anaphylaxis to insect poison, in whom well-standardised single-component "vaccines" were used. IT was only used adequately in 36.4% of cases (71.4% in asthma, 46.1% in naso-bronchial allergy, and 18.7% in rhinitis). The high prescription of accompanying medication should be highlighted: oral H1 anti-histamines (81.8%), inhaled steroids for asthma (42.4%) and nasal steroids for rhinitis (72.4%). CONCLUSIONS: Use of IT in our health district is poorly suited to the indications based on contrasted scientific evidence. Clinical practice guidelines must be agreed at all care levels so as to improve the quality of care for all allergy patients.
OBJECTIVE: To analyse the appropriateness of specific immunotherapy treatment (IT) to indications based on scientific evidence. DESIGN: Cross-sectional, descriptive study. SETTING: Primary care in a health district of about 12,000 inhabitants. PATIENTS: 166 patients for whom IT was prescribed in the period between January 1998 and June 1999 were included. The full evaluation covered 65 patients whose allergy report was available in their clinical records. MEASUREMENTS AND RESULTS: IT prescription was considered adequate in patients with single sensitivity to respiratory allergy or anaphylaxis to insect poison, in whom well-standardised single-component "vaccines" were used. IT was only used adequately in 36.4% of cases (71.4% in asthma, 46.1% in naso-bronchial allergy, and 18.7% in rhinitis). The high prescription of accompanying medication should be highlighted: oral H1 anti-histamines (81.8%), inhaled steroids for asthma (42.4%) and nasal steroids for rhinitis (72.4%). CONCLUSIONS: Use of IT in our health district is poorly suited to the indications based on contrasted scientific evidence. Clinical practice guidelines must be agreed at all care levels so as to improve the quality of care for all allergypatients.