Allergy Training For Nurses Improves Patients' Quality Of Life; New Research Provides The Evidence

Recent research published by Education for Health and colleagues from the University of Edinburgh, the University of Aberdeen and the London School of Hygiene and Tropical Medicine provides evidence that structured allergy training for primary care health professionals improves quality of life in patients with perennial rhinitis(1).

In this randomised, controlled trial, twenty GPs and practice nurses completed the allergy module at Education for Health over a six month period. Patients with perennial rhinitis (blocked, runny nose) from these doctors' and nurses' practices were randomly allocated to either receive care from an allergy trained doctor or nurse or from an untrained person (usual care). All patients then completed a disease-specific quality of life questionnaire which looked at the impact of their nasal symptoms on their quality of life at baseline and at 6 months.

Results showed not only that the trained nurses and doctors were more confident and competent in delivering allergy care, but that their patients' quality of life was improved compared to those patients who had continued with their usual care. This research is important on two counts, firstly, it supports the NHS agenda of improving primary care allergy services by showing that allergy training is feasible and deliverable in primary care; and secondly, that patients benefit as a result of health professional education.

Monica Fletcher, Chief Executive of Education for Health said "Most mild or moderate allergy symptoms (e.g. hayfever, allergic asthma, urticaria and some food allergy problems), can, and should, be managed successfully in primary care with appropriate training. A recent House of Commons Health Committee report on the provision of allergy services(2) echoed this view. Clinical quality markers for allergy care must be included in the GMS contract in the future. Both publications stress the importance of postgraduate training to improve allergy practice in primary care".

Allergic diseases, including hayfever (allergic rhinitis), food allergy, drug allergy and allergic asthma affect approximately 20% of the UK population and account for approximately 6% of GP consultations. Hospital admissions for severe allergic disease have increased tenfold in the last 10 years and allergy generally is associated with significant financial cost. Symptoms can be irritating, disruptive and sometimes disabling; allergic rhinitis, often trivialised by sufferers and health professionals alike, has been shown to impair concentration and learning in children.

Mark Levy, GP with interest in Respiratory diseases and Allergy said: "Despite the high prevalence and morbidity due to allergic diseases in the United Kingdom, a small minority of health professionals are trained in provision of allergy care (4, 5). Furthermore the lack of facilities for secondary and tertiary care for people with allergic conditions, coupled with the relatively small number of specialists available to teach allergy management in primary care, has resulted in patients being managed by health professionals with little formal training in this discipline (6). This study from Education for Health, offers some hope for patients and information for commissioners of health care by providing good quality evidence of the benefit for allergy sufferers in being treated by health professionals trained in this field."

Education for Health provides Allergy training at diploma and degree level.

References:

(1) Sheikh A, Khan-Wasti S, Price D, Smeeth L, Fletcher M, Walker S. Standardized training for healthcare professionals and its impact on patients with perennial rhinitis: a multi-centre randomized controlled trial. J Allergy Clin Immunol 2007; 37:90-99

(2) Department of Health. A Review of services for allergy. The epidemiology, demand for, and provision of, treatment and effectiveness of clinical interventions. http://www.dh.gov.uk. 2006

(3) Walker SM & Sheikh A. Self-reported rhinitis is a significant problem for patients with asthma: results from a national (UK) survey. Primary Care Resp J. 2005;14:83-87

(4) Mark L Levy, David Price, Xiaohong Zheng, Colin Simpson, Phil Hannaford and Aziz Sheikh. Inadequacies in UK primary care allergy services: National survey of current provisions and perceptions of need. Clinical and Experimental Allergy, 2004; 34(4): 518-519

(5) http://dx.doi.org/10.3132/pcrj.2007.00004

(6) Mark L Levy, Aziz Sheikh, Samantha Walker, Angie Woods. Should UK allergy services focus on primary care? BMJ 2006;332:1347-1348. doi:10.1136/bmj.332.7554.1347 http://bmj.bmjjournals.com/cgi/content/extract/332/7554/1347

Education for Health
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Facts about Education for Health:

-- Education for Health is a not for profit organisation formed by a dynamic merger in August 2005 between two of the UK's leading education organisations for health professionals: Heartsave - National Cardiovascular Training Programme, and the National Respiratory Training Centre.

-- The two partner organisations have each earned a reputation for excellence in education in their respective areas of expertise and have trained in excess of 40,000 students both nationally and internationally. Prior to the establishment of Education for Health, The National Respiratory Training Centre had been at the frontline of the battle to achieve recognition for people with lung disease since 1986.

-- Education for Health aims to provide a consistent, comprehensive and innovative approach to professional health education across the fields of cardiovascular disease, allergy, and respiratory health, with the ultimate objective of transforming lives worldwide

-- All education is evidence based and grounded in practice; fully up to date with the General Medical Services Contract; based on key national guidelines; directly linked with the competency frameworks and Knowledge and Skills Framework; and is subject to frequent, rigorous clinical and academic review. In addition, in these days of Health Service change and uncertainty, all students are fully supported throughout their studies by a team of clinical experts.