Children's Health Ireland at Tallaght University Hospital, Tallaght, Dublin 24, Ireland.
Children's Health Ireland at Crumlin, Crumlin, Dublin 12, Ireland.
Ir J Med Sci. 2023 Jun;192(3):1271-1276. doi: 10.1007/s11845-022-03067-x. Epub 2022 Jul 8.
Allergen immunotherapy (AIT) is a safe, effective and disease-modifying treatment for allergic rhinitis. It is indicated for children with moderate to severe disease whose symptoms persist despite conventional therapy. There is a high prevalence of allergic rhinitis amongst Irish children; however, levels of AIT prescribing in Ireland are lower than neighbouring countries.
The aims of this study are to describe current patterns of AIT prescribing and referrals amongst Irish paediatricians and to identify barriers to accessing AIT in Ireland.
An electronic questionnaire was distributed to all paediatricians and paediatric trainees caring for children with allergic rhinitis.
A lack of knowledge of AIT clinical criteria was the most frequently reported barrier with 50.5% (50/99) of general paediatricians unaware of the indications for referral compared to 27.3% (3/11) of respiratory physicians and 0% (0/8) of allergists. Accessibility is the next most cited barrier with 31.4% (37/118) of respondents unsure where to refer and 19.5% (23/118) reporting a lack of local services. Cost was reported to be a barrier by 12.7% (15/118). Paediatricians with an allergy or respiratory subspecialisation reported seeing significantly higher numbers of children with allergic rhinitis and were more likely to prescribe or refer a child for AIT.
This study demonstrated positive attitudes towards AIT amongst all grades and specialities of paediatricians in Ireland. The main barriers to more widespread use are difficulties with the identification of suitable candidates by general paediatricians and a lack of local AIT services and referral pathways.
变应原免疫疗法（AIT）是一种安全、有效且可改变疾病进程的治疗方法，适用于过敏症状持续存在且经常规治疗无效的中重度过敏性鼻炎患儿。爱尔兰儿童过敏性鼻炎的发病率较高，但爱尔兰的 AIT 处方率低于邻国。
本研究旨在描述爱尔兰儿科医生 AIT 处方和转诊的现状，并确定爱尔兰接受 AIT 治疗的障碍。
我们向所有治疗过敏性鼻炎儿童的儿科医生和儿科实习生发放了电子问卷。
缺乏 AIT 临床标准的相关知识是最常被报道的障碍，50.5%（50/99）的普通儿科医生不知道转诊的指征，而呼吸科医生的这一比例为 27.3%（3/11），过敏科医生为 0%（0/8）。其次是可及性障碍，31.4%（37/118）的受访者不确定应向何处转诊，19.5%（23/118）的受访者报告缺乏当地服务。12.7%（15/118）的受访者表示费用是一个障碍。有过敏或呼吸专科亚专业背景的儿科医生报告称，他们接触到的过敏性鼻炎患儿数量明显更多，并且更有可能为患儿开具 AIT 处方或转诊。
本研究表明爱尔兰各级儿科医生对 AIT 持积极态度。限制其广泛应用的主要障碍是普通儿科医生难以识别合适的候选者，以及缺乏当地 AIT 服务和转诊途径。
