Gleeson Patrick K, Morales Knashawn H, Buckey Timothy M, Fadugba Olajumoke O, Apter Andrea J, Christie Jason D, Himes Blanca E
Section of Allergy and Immunology, Division of Pulmonary, Allergy and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pa.
J Allergy Clin Immunol Glob. 2023 Sep 9;2(4):100167. doi: 10.1016/j.jacig.2023.100167. eCollection 2023 Nov.
Aeroallergen testing informs precision care for adults with asthma, yet the epidemiology of testing in this population remains poorly understood.
We sought to identify factors associated with receiving aeroallergen testing, the results of these tests, and subsequent reductions in exacerbation measures among adults with asthma.
We used electronic health record data to conduct a retrospective, observational cohort study of 30,775 adults with asthma who had an office visit with a primary care provider or an asthma specialist from January 1, 2017, to August 26, 2022. We used regression models to identify (1) factors associated with receiving any aeroallergen test and tests to 9 allergen categories after the index visit, (2) factors associated with positive test results, and (3) reductions in asthma exacerbation measures in the year after testing compared with before testing.
Testing was received by 2201 patients (7.2%). According to multivariable models, receiving testing was associated with having any office visit with an allergy/immunology specialist during the study period (odds ratio [OR] = 91.3 vs primary care only [ < .001]) and having an asthma emergency department visit (OR = 1.62 [ = .004]) or hospitalization (OR = 1.62 [ = .03]) in the year before the index visit. Age 65 years or older conferred decreased odds of testing (OR = 0.74 vs age 18-34 years [ = .008]) and negative test results to 6 categories ( ≤ .04 for all comparisons). Black race conferred increased odds of testing (OR =1.22 vs White race [ = .01]) and positive test results to 8 categories ( < .04 for all comparisons). Exacerbation measures decreased after testing.
Aeroallergen testing was performed infrequently among adults with asthma and was associated with reductions in asthma exacerbation measures.
空气过敏原检测可为成年哮喘患者提供精准治疗，但该人群的检测流行病学仍知之甚少。
我们试图确定与成年哮喘患者接受空气过敏原检测、检测结果以及随后加重症状措施减少相关的因素。
我们利用电子健康记录数据，对2017年1月1日至2022年8月26日期间到初级保健提供者或哮喘专科医生处就诊的30775名成年哮喘患者进行了一项回顾性观察队列研究。我们使用回归模型来确定：（1）与接受任何空气过敏原检测以及在首次就诊后检测9种过敏原类别相关的因素；（2）与检测结果呈阳性相关的因素；（3）与检测前相比，检测后一年哮喘加重症状措施的减少情况。
2201名患者（7.2%）接受了检测。根据多变量模型，接受检测与在研究期间与过敏/免疫专科医生进行过任何门诊就诊有关（比值比[OR]=91.3，仅与初级保健相比[<0.001]），以及在首次就诊前一年有哮喘急诊就诊（OR=1.62[P=0.004]）或住院（OR=1.62[P=0.03]）。65岁及以上的年龄降低了检测的几率（OR=0.74，与18-34岁相比[P=0.008]）以及6种类别检测结果为阴性的几率（所有比较P≤0.04）。黑人种族增加了检测的几率（OR=1.22，与白人种族相比[P=0.01]）以及8种类别检测结果为阳性的几率（所有比较P<0.04）。检测后加重症状措施有所减少。
成年哮喘患者中空气过敏原检测的执行频率较低，且与哮喘加重症状措施的减少有关。
