Bruce G Bender PhD Ann Allergy Asthma Immunol July 201812112430 Where does health communication technology fit into allergy practice Key Messages Adherence interventions to date have been only moderately successful ID: 935731
Download Presentation The PPT/PDF document "Where does health communication technolo..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Slide2Where does health communication technology fit into allergy practice?
Bruce G. Bender, PhD
Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide3Where does health communication technology fit into allergy practice?
Key Messages
Adherence interventions to date have been only moderately successful.
Health communication technology brings new possibilities for improved asthma self-management.
New biosensors, such as smartphone-compatible fractional exhaled nitric oxide and spirometers, could provide additional benefits.
Allergists must exercise caution so that HCTs do not compromise patient confidentiality or safety.Bender BG. Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide4Timeline of Existing and New Technology Emergence
Bender BG. Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide5Fluticasone and Salmeterol Refill Rates in
5,500
Patients Over 365 Days
Bender BG. Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide6Effect Size of Adherence Interventions
Bender BG. Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide7Translational Sequence for Health
Behavior
Research
Bender BG. Ann Allergy Asthma Immunol. July 2018;121(1):24-30
Slide8Integrated Behavioral Health Care for
Management
of Stress in Allergic Diseases
Alyssa A. Oland, PhD
Genery D. Booster, PhD
Bruce G. Bender, PhD
Ann Allergy Asthma Immunol. July 2018;121(1):31-36
Slide9Integrated Behavioral Health Care for
Management of
Stress in Allergic Diseases
Key Messages
Oland AA
, Booster GD, Bender BG. Ann Allergy Ashma Immunol. July 2018;121(1):31-36
There is an increasing prevalence and severity of allergic disease worldwide.
A bidirectional relationship has been found between allergic disease and stress, particularly for patients with severe, chronic, or multiple allergic diseases; physiological and behavioral pathways contribute to this bidirectional relationship.
Behavioral health interventions are helpful in addressing stress and nonadherence in patients with allergic disease.
Medical providers are encouraged to routinely screen for behavioral health and make referrals as indicated or, ideally, incorporate a behavioral health provider into a multidisciplinary patient care team.
School, workplace, and community-level interventions are
also
indicated
for supporting patients with allergic disease.
Slide10Barriers to Medication Adherence in Asthma:
The Importance of Culture and Context
Elizabeth L. McQuaid, PhD
Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide11Barriers to Medication Adherence in Asthma:
The Importance of Culture and Context
Key Messages
McQuaid EL. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
There are racial and ethnic disparities in the use of controller medications for asthma in prescription receipt, prescription initiation, and medication adherence once obtained.
Individual factors such as culturally derived medication concerns and depressive symptoms play a role.Patients with severe asthma or those with financial burdens may consider complementary and alternative medicine (CAM) as a supplemental or alternative strategy to traditional medications.Patient-provider variables, such as limited discussion of CAM use, difficulties communicating with limited English proficiency patients, and cultural stereotypes, likely influence lower levels of adherence.
Office-based interventions (providing education, simplifying regimens, monitoring) may be effective if delivered in a culturally informed manner.
Provider training in communication and cultural competence may increase
patient receptivity to discussing and accepting controller medications.
Slide12Components of Medication Adherence
McQuaid EL. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide13Intervention Approaches to Address
Disparities
in Medication Use
McQuaid EL. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide14The Burden of Allergic Rhinitis and Allergic Rhinoconjunctivitis on Adolescents:
A Literature Review
Michael S. Blaiss, MD
Eva Hammerby, MSc
Susan Robinson, PhD
Tessa Kennedy-Martin, MSc
Sarah Buchs, MsC
Ann Allergy Asthma Immunol. July 2018;121(1):43-52
Slide15The Burden of Allergic Rhinitis and Allergic Rhinoconjunctivitis on Adolescents: A Literature Review
Key Messages
Blaiss MS,
Hammerby E, Robinson S, et
al. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Although allergic rhinitis (AR) and allergic rhinoconjunctivitis (ARC) are sometimes perceived as trivial conditions, this review indicates that their impact on adolescent life is negative and far-reaching. It is important that the disease burden should be examined in adolescents as they represent a unique population with needs that are distinct from adults and younger children.The symptoms associated with AR and ARC can be different in adolescents compared with adults and children.AR/ARC has been shown to have a significant impact on the quality of life (QOL) of adolescents with respect to both physical and mental components, and may limit daily activities and functioning in these individuals.Adolescents with AR/ARC may experience difficulties falling asleep, night waking, and snoring, and generally have poorer sleep.
AR/ARC has a negative impact on school attendance, performance, and academic achievement.
Improved management of AR and ARC could help to reduce the disease burden across a number of important patient-reported outcomes, such as QOL, daily functioning, sleep,
and
academic
performance, in adolescents.
Slide16Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Flowchart of Search Results
Blaiss MS, Hammerby E, Robinson S, et al. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide17Association Between Moderate to Severe Seasonal Allergic Rhinitis Symptoms and Poor Rhinoconjunctivitis Quality of Life Questionnaire Score in Adolescents, Children, and Adults
Blaiss MS, Hammerby E, Robinson S, et al. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide18Associations Among Allergic Rhinitis (AR), AR medication, and Asthma in Adolescents
(
aged 15–17 years) Taking UK National Examinations
Blaiss MS, Hammerby E, Robinson S, et al. Ann Allergy Asthma Immunol. July 2018;121(1):37-42
Slide19Epinephrine, Auto-injectors, and Anaphylaxis:
Challenges of Dose, Depth, and Device
Julie C. Brown, MDCH, MPH
Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide20Epinephrine, Auto-injectors, and Anaphylaxis: Challenges of Dose, Depth, and Device
Key Messages
Brown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Epinephrine is the only first-line medication for the treatment of anaphylaxis, and it must be readily available in the community, with doses and exposed needle lengths that are optimized to best meet the needs of patients of all sizes and weights.
Optimal dosing is based on common practice, but it is not well studied. No pharmacokinetic or pharmacodynamic data involving patients in anaphylaxis are available.
The recently marketed 0.1 mg epinephrine auto-injector (EAI) is the first approved device for patients weighing 7.5 to 15 kg, which allows for dosing closer to the recommended 0.01 mg/kg. It also has a shorter needle that may be more appropriate for this weightrange.The 0.15-mg EAI gives increasingly less than the recommended 0.01 mg/kg dose as the patient weight approaches 30 kg. Data are lacking to determine whether this is clinically important, but switching at 20 or 25 kg may be better than switching at 30 kg.
A higher-dose EAI might better meet the needs of larger patients, but data are lacking.
An EAI with a longer needle might better meet the needs of obese patients, but data are lacking.
Prehospital and hospital providers should review their anaphylaxis preparedness and
consider
using anaphylaxis kits or prefilled syringes when EAIs are not used.
Slide21Epinephrine dose percentage above and below a 0.01 mg/kg ideal, by weight at which the switch between 0.15-mg and
0.3-mg devices is made (20 kg, 25 kg, or 30 kg)
Brown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide22Epinephrine dosing compared with a 0.01-mg/kg
ideal
, using a 4 epinephrine auto-injector (EAI)
strategy
vs
a 2 EAI strategyBrown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide23Administration of an epinephrine auto-injector to a well-restrained infant, demonstrating how a single holder can bunch the thigh muscle during administration to increase the skin-to-bone depth
Brown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide24Epinephrine 1-mg/mL vial and supply kit for anaphylaxis, prepared by the inpatient pharmacy and stocked wherever
1
mg/mL epinephrine is needed throughout the hospital
Brown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide25Emergency
Epinephrine
Check-and-Inject
Kit
for
Emergency Medical Service ProvidersBrown JC. Ann Allergy Asthma Immunol. July 2018;121(1):53-60
Slide26Advances in Rhinitis:
Models and Mechanisms
Anne K. Ellis, MD, MSc, FRCPC
Mark W. Tenn, BHSc
Ann Allergy Asthma Immunol. July 2018;121(1):61-64
Slide27Advances in Rhinitis: Models and Mechanisms
Key Messages
Ellis AK, Tenn MW. Ann Allergy Asthma Immunol. July 2018;121(1):61-64
The nasal microbiome is a diverse community of bacteria that can be found throughout the nose and sinuses.
Bacteria in the nose and nasal microbiome profiles can be detected shortly after birth.
Staphylococcus aureus is a key pathogenic bacterium in chronic rhinosinusitis with nasal polyps; however, this may be dependent on the phenotype and severity of disease.Probiotics can potentially improve clinical efficacy of immunotherapies and anti-histamines in treatment plans of allergic rhinitis, but this requires further evidence.