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DHBs need urgent improvement in allergy services

20th of May

Each of the country’s 21 district health boards and the Ministry of Health are being presented with a submission this week, pushing for urgent improvements in allergy services for New Zealand’s estimated 800,000 sufferers.

Allergy New Zealand, a national organisation dedicated to raising awareness of allergies and providing support and information to sufferers, is making the submissions as part of Allergy Awareness Week (18-24 May 2008).

“The prevalence of allergic disease has significantly increased, and New Zealand has one of the highest prevalence in the Western world with about 20 per cent of the population affected¹,²,” said Allergy New Zealand’s chief executive, Penny Jorgensen. “There is increasing evidence of the hardship this causes, but health services have failed to keep up.”

Thousands of patients are likely to be suffering unnecessarily — some of whom are at risk of life-threatening reactions — due to the lack of resources to enable the effective management of allergic diseases at primary levels of healthcare, the submission states.

“There has been a shift in focus in the health system to chronic conditions but this tends to be on conditions with high mortality and morbidity rates. And we accept that,” Mrs Jorgensen said.

“But allergic disease has so many side effects that it also needs to be recognised as a chronic condition that needs to be effectively managed.”

It’s a significant underlying cause of avoidable hospital admissions, including for asthma and anaphylaxis (a potentially life-threatening allergic reaction), and repeat GP visits for conditions such as eczema, ear and chest infections, conjunctivitis and colic in infants3,4.

Recent studies on the quality of life for people with allergic diseases found the adverse impact is significant and largely hidden, even for the relatively “mild” condition of rhinitis (or hay fever)5-8.

The submission highlights the disparity in access to diagnostic services across the country. The provision of laboratory tests such as skin prick and RAST (blood) tests appears to be related to budgetary concerns rather than best practice for the diagnosis for allergic disease.

As a result, many patients feel their conditions have not been properly diagnosed, and that the treatment and advice they’re given is incorrect, or inadequate or sometimes unsafe.

“We acknowledge that there is a lack of allergy specialists in New Zealand, and it probably won’t get better in the near future, but we need to make a commitment now and need to commit resources for the longer term otherwise we will lose our specialists and we will be in an even worse position,” Mrs Jorgensen said.

“We accept that it’s not possible for every DHB to provide an allergy or immunology service, so there needs to be a coordinated national approach. The DHBs, the Ministry of Health and the New Zealand Clinical Immunology and Allergy Group need to find ways to develop publicly funded allergy and immunology services so that provision for patients is equitable, based on need and to international best practice.”

Mrs Jorgensen says Allergy New Zealand is making these submissions to the individual DHBs because the organisation’s understanding is that the boards are responsible for prioritisation decisions, including decisions about levels of service and how that service is provided.

People can buy Peter Leitch’s new book, “What a Ride, Mate! The Life and Times of the Mad Butcher”. Peter Leitch, whose grandson suffers from life-threatening food allergies, is Allergy New Zealand’s Ambassador and is donating half the proceeds to the organisation.

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References:

1. ASCIA, “The Economic Impact of allergic disease in Australia: not to be sneezed at”, Access Economics, November 2007.
2. I Asher et al, “Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis and eczema in childhood: ISAAC phases one and three repeat multi-country cross-sectional surveys”, The Lancet 2006; 368: 733-43
3 H.P. van Bever & P.C. Potter, “Making the allergic child happy: treating more than symptoms”, Clinical & Experimental Allergy, 2006.
4. L M Poulus et al, “Trends in hospitalizations for anaphylaxis, angiodema, and urticaria in Australia, 1993-1994 to 2004-2005”, Journal of Allergy & Clinical Immunology, Vol 120, No 4. October 2007.
5. Marklund B; Ahlstedt S; Nordström G, “Health-Related Quality Of Life In Food Hypersensitive Schoolchildren And Their Families: Parents' Perceptions”, Health Qual Life Outcomes. 2006; ©2006 BioMed Central
6. O'Hollaren MT, “The Impact of Food Allergies on the Quality of Family Life”, Medscape Allergy & Clinical Immunology. 2006; 6(1) ©2006
7. M E Bollinger et al ,“The impact of food allergy on the daily activities of children and their families”, Annals of Allergy Asthma and Immunology. 2006; 96(3):415-21
8. W F Schoenwetter et al, “Economic Impact and Quality-of-Life Burden of Allergic Rhinitis,” Curr Med Res Opin 20(3):305-317, 2004..