Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador
Background The current EAACI/GA2LEN/EDF/WAO guideline for urticaria provide specific recommendations for the diagnostic workup and treatment of patients with chronic spontaneous urticaria (CsU). This study explored if physicians in Ecuador know these recommendations and implement them in their actua...
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| Format: | Article |
| Language: | English |
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Elsevier
2017-01-01
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| Series: | World Allergy Organization Journal |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455119300195 |
| _version_ | 1818992980105625600 |
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| author | A. Cherrez M. Maurer K. Weller J.C. Calderon D. Simancas-Racines I. Cherrez Ojeda |
| author_facet | A. Cherrez M. Maurer K. Weller J.C. Calderon D. Simancas-Racines I. Cherrez Ojeda |
| author_sort | A. Cherrez |
| collection | DOAJ |
| description | Background The current EAACI/GA2LEN/EDF/WAO guideline for urticaria provide specific recommendations for the diagnostic workup and treatment of patients with chronic spontaneous urticaria (CsU). This study explored if physicians in Ecuador know these recommendations and implement them in their actual clinical practice for CsU.Methods We investigated physicians who treat CsU patients in a cross-sectional study using a standardized questionnaire. Descriptive statistics were employed, adjusted logistic regression was performed to assess the link of guideline knowledge and use of therapy.Results Seven hundred forty surveys were collected and analyzed. The mean age of physicians was 42.3 (±12.5) years. Most of the participants (65.1%) were general physicians (GP), 13.7% were pediatricians, 11.0% internists, 6.8% dermatologists or allergists (D/A). Only 18.8% knew the EAACI/GA2LEN/EDF/WAO guideline. 44.5% of GPs searched for CsU etiology in contrast to 90% of D/A. Most common diagnostic test was total serum IgE (83.5%). Most common first line symptomatic treatment was oral corticoids (46.3%), followed by second generation antihistamines (sgAHs, 36.8%). A/D prescribed more sgAHs (regular doses) (74.1 vs 28.6% of GP) (p < 0.05). Experience with omalizumab was reported only by 3.5%, of physicians, and higher rates among who were familiar with the guideline.Conclusion This study shows that the knowledge of guideline recommendations in physicians who treat urticaria patients in Ecuador is low. The diagnostic workup and treatment of CsU patients are largely not in line with guideline recommendations in real life practice settings. We were able to compare results between German and Ecuadorian physicians and found that Ecuadorian physicians have lower awareness of the current guideline (33 vs 18%). Only one-third of physicians reported using regular doses of sgAHs as the first line treatment. Also, only 12.9% of physicians use sgAHs in higher doses and physicians still use fgAHs, particularly pediatricians (42.9%). Our results suggest that disparities in knowledge between physicians from different countries could influence the management of CsU. Knowledge of the guidelines is linked to better choices of treatments. Awareness of guidelines needs to be promoted for better management of chronic urticaria. Keywords: Chronic urticaria, Guidelines, Latin America, Management, Treatment |
| first_indexed | 2024-12-20T20:34:46Z |
| format | Article |
| id | doaj.art-8f6368246c3c43a9b025a8ba5a8b8ffe |
| institution | Directory Open Access Journal |
| issn | 1939-4551 |
| language | English |
| last_indexed | 2024-12-20T20:34:46Z |
| publishDate | 2017-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj.art-8f6368246c3c43a9b025a8ba5a8b8ffe2022-12-21T19:27:15ZengElsevierWorld Allergy Organization Journal1939-45512017-01-01101Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in EcuadorA. Cherrez0M. Maurer1K. Weller2J.C. Calderon3D. Simancas-Racines4I. Cherrez Ojeda5Respiralab Research Group, Respiralab, Guayaquil, Ecuador; School of Medicine, University of Heidelberg, Heidelberg, GermanyDepartment of Dermatology and Allergy, Allergie-Centrum-Charité, Charité – Universitätsmedizin Berlin, Berlin, GermanyDepartment of Dermatology and Allergy, Allergie-Centrum-Charité, Charité – Universitätsmedizin Berlin, Berlin, GermanyRespiralab Research Group, Respiralab, Guayaquil, Ecuador; School of Medicine, Universidad Espiritu Santo, Samborondón, Guayas, EcuadorCentro de Investigación en Salud Pública y Epidemiologia Clínica, Facultad de Ciencias de la Salud Eugenio Espejo, Universidad Tecnológica Equinoccial, Quito, EcuadorRespiralab Research Group, Respiralab, Guayaquil, Ecuador; School of Medicine, Universidad Espiritu Santo, Samborondón, Guayas, Ecuador; Correspondence:Background The current EAACI/GA2LEN/EDF/WAO guideline for urticaria provide specific recommendations for the diagnostic workup and treatment of patients with chronic spontaneous urticaria (CsU). This study explored if physicians in Ecuador know these recommendations and implement them in their actual clinical practice for CsU.Methods We investigated physicians who treat CsU patients in a cross-sectional study using a standardized questionnaire. Descriptive statistics were employed, adjusted logistic regression was performed to assess the link of guideline knowledge and use of therapy.Results Seven hundred forty surveys were collected and analyzed. The mean age of physicians was 42.3 (±12.5) years. Most of the participants (65.1%) were general physicians (GP), 13.7% were pediatricians, 11.0% internists, 6.8% dermatologists or allergists (D/A). Only 18.8% knew the EAACI/GA2LEN/EDF/WAO guideline. 44.5% of GPs searched for CsU etiology in contrast to 90% of D/A. Most common diagnostic test was total serum IgE (83.5%). Most common first line symptomatic treatment was oral corticoids (46.3%), followed by second generation antihistamines (sgAHs, 36.8%). A/D prescribed more sgAHs (regular doses) (74.1 vs 28.6% of GP) (p < 0.05). Experience with omalizumab was reported only by 3.5%, of physicians, and higher rates among who were familiar with the guideline.Conclusion This study shows that the knowledge of guideline recommendations in physicians who treat urticaria patients in Ecuador is low. The diagnostic workup and treatment of CsU patients are largely not in line with guideline recommendations in real life practice settings. We were able to compare results between German and Ecuadorian physicians and found that Ecuadorian physicians have lower awareness of the current guideline (33 vs 18%). Only one-third of physicians reported using regular doses of sgAHs as the first line treatment. Also, only 12.9% of physicians use sgAHs in higher doses and physicians still use fgAHs, particularly pediatricians (42.9%). Our results suggest that disparities in knowledge between physicians from different countries could influence the management of CsU. Knowledge of the guidelines is linked to better choices of treatments. Awareness of guidelines needs to be promoted for better management of chronic urticaria. Keywords: Chronic urticaria, Guidelines, Latin America, Management, Treatmenthttp://www.sciencedirect.com/science/article/pii/S1939455119300195 |
| spellingShingle | A. Cherrez M. Maurer K. Weller J.C. Calderon D. Simancas-Racines I. Cherrez Ojeda Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador World Allergy Organization Journal |
| title | Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador |
| title_full | Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador |
| title_fullStr | Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador |
| title_full_unstemmed | Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador |
| title_short | Knowledge and management of chronic spontaneous urticaria in Latin America: a cross-sectional study in Ecuador |
| title_sort | knowledge and management of chronic spontaneous urticaria in latin america a cross sectional study in ecuador |
| url | http://www.sciencedirect.com/science/article/pii/S1939455119300195 |
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