Intended for healthcare professionals

Clinical Review ABC of allergies

Allergy in general practice

BMJ 1998; 316 doi: (Published 23 May 1998) Cite this as: BMJ 1998;316:1584
  1. Sue Cross,
  2. Sallie Buck,
  3. Jane Hubbard

    In parallel with the known increases in atopy (confirmed by a positive response in skin prick testing to one or more common allergens) and allergy there has been a marked increase in the proportion of general practitioner consultations for asthma, hay fever, and eczema. A greater awareness of the importance of allergy should lead to better diagnosis and management of allergy. This is essential for perennial allergic asthma in children and adults, in whom environmental control and allergen avoidance measures directed against house dust mites are of proved value in reducing asthma symptoms and bronchial hyperresponsiveness. It seems likely that these factors also reduce the need for drug treatment.

    House dust mite, the major cause of perennial allergy in Britain

    Rhinitis symptoms commonly have an allergic aetiology and may be seasonal or perennial. They may be responsible for severe impairment of quality of life. Rhinitis symptoms are frequently trivialised and misdiagnosed by both patients and doctors as “the permanent cold.” This is unfortunate as avoidance measures combined with either topical corticosteroids or antihistamines, or both, are extremely effective in controlling symptoms with minimal side effects. Recent surveys have suggested that up to 80% of people with asthma also have rhinitis; treating rhinitis in such people has been shown to reduce asthma symptoms and bronchial hyperresponsiveness.

    Some common problems (such as adverse reactions to drugs) and less common conditions (such as occupational asthma and anaphylaxis) that are due to allergy may be life threatening and require referral to a specialist allergy clinic

    Role of the practice nurse

    The practice nurse has a major (and now established) role in the routine care of asthmatic patients in general practice. It seems logical that this role of the specially trained nurse could be extended, with the support of the general practitioner, to include the recognition and treatment of the …

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