Abstract
Background: Several reports show deficiencies in the knowledge of physicians about the diagnostic criteria and the treatment of anaphylaxis, a condition that can have fatal consequences.
Objective: To evaluate the knowledge of physicians in Colombia on the fundamental aspects of anaphylaxis in diagnosis and treatment.
Methods: Analytical cross-sectional study, carried out through a survey of 11 questions that evaluate clinical aspects of anaphylaxis, addressed to general practitioners and specialists in different health areas resident in Colombia. The analysis of the results was based on the correct answers. For approval, a score higher than 70% was needed.
Results: A total of 447 non-allergic doctors analyzed were included, of which only 110 (24.6%) approved the questionnaire in both the questions aimed at the diagnosis and in the treatment of anaphylaxis. Among the factors that were associated with the failure of the survey were the age of the doctor (p <0.01) and work at the first level of care (p <0.01).
Conclusions: Like previous studies, knowledge in the diagnosis and treatment of anaphylaxis is scarce among Colombian physicians. The factors associated with said result are potentially modifiable.
References
Simons FE, Ardusso LR, Dimov V, Ebisawa M, El-Gamal YM, Lockey RF, et al. World Allergy Organization Anaphylaxis Guidelines: 2013 update of the evidence base. Int Arch Allergy Immunol. 2013;162(3):193-204. DOI: 10.1159/000354543
Tejedor-Alonso MA, Moro-Moro M, Múgica-García MV. Epidemiology of anaphylaxis: contributions from the last 10 years. J Investig Allergol Clin Immunol. 2015;25(3):163-175. Disponible en: http://www.jiaci.org/issues/vol25issue3/1.pdf
Campbell RL, Li JT, Nicklas RA, Sadosty AT, Force Mot JT, Workgroup PP, et al. Emergency department diagnosis and treatment of anaphylaxis: a practice parameter. Ann Allergy Asthma Immunol. 2014;113(6):599-608. DOI: 10.1016/j.anai.2014.10.007
Campbell RL, Hagan JB, Manivannan V, Decker WW, Kanthala AR, Bellolio MF, et al. Evaluation of national institute of allergy and infectious diseases/food allergy and anaphylaxis network criteria for the diagnosis of anaphylaxis in emergency department patients. J Allergy Clin Immunol. 2012;129(3):748-752. DOI: 10.1016/j.jaci.2011.09.030
Bohlke K, Davis RL, DeStefano F, Marcy SM, Braun MM, Thompson RS, et al. Epidemiology of anaphylaxis among children and adolescents enrolled in a health maintenance organization. J Allergy Clin Immunol. 2004;113(3):536-542. DOI: 10.1016/j.jaci.2003.11.033
Lieberman P, Nicklas RA, Randolph C, Oppenheimer J, Bernstein D, Bernstein J, et al. Anaphylaxis: a practice parameter update 2015. Ann Allergy Asthma Immunol. 2015;115(5):341-384. DOI: 10.1016/j.anai.2015.07.019
Pajno GB, Fernández-Rivas M, Arasi S, Roberts G, Akdis CA, Álvaro-Lozano M, et al. EAACI Guidelines on allergen immunotherapy: IgE-mediated food allergy. Allergy. 2018;73(4):799-815. DOI: 10.1111/all.13319
Baalmann DV, Hagan JB, Li JT, Hess EP, Campbell RL. Appropriateness of epinephrine use in ED patients with anaphylaxis. Am J Emerg Med. 2016;34(2):174-179. DOI: 10.1016/j.ajem.2015.10.003
Grossman SL, Baumann BM, García-Peña BM, Linares MY, Greenberg B, Hernández-Trujillo VP. Anaphylaxis knowledge and practice preferences of pediatric emergency medicine physicians: a national survey. J Pediatr. 2013;163(3):841-846. DOI: 10.1016/j.jpeds.2013.02.050
Jares EJ, Baena-Cagnani CE, Sánchez-Borges M, Ensina LF, Arias-Cruz A, Gómez M, et al. Drug-induced anaphylaxis in Latin American countries. J Allergy Clin Immunol Pract. 2015;3(5):780-788. DOI: 10.1016/j.jaip.2015.05.012
Sánchez J, Sánchez A. Epidemiology of food allergy in Latin America. Allergol Immunopathol (Madr). 2015;43(2):185-195. DOI: 10.1016/j.aller.2013.07.001
Solé D, Ivancevich JC, Borges MS, Coelho MA, Rosario NA, Ardusso LR, et al. Anaphylaxis in Latin America: a report of the online Latin American survey on anaphylaxis (OLASA). Clinics (Sao Paulo). 2011;66(6):943-947. DOI: 10.1590/S1807-59322011000600004
Jares EJ, Sánchez-Borges M, Cardona-Villa R, Ensina LF, Arias-Cruz A, Gómez M, et al. Multinational experience with hypersensitivity drug reactions in Latin America. Ann Allergy Asthma Immunol. 2014;113(3):282-289. DOI: 10.1016/j.anai.2014.06.019
Caraballo L, Zakzuk J, Lee BW, Acevedo N, Soh JY, Sánchez-Borges M, et al. Particularities of allergy in the Tropics. World Allergy Organ J. 2016;9:20. DOI: 10.1186/s40413-016-0110-7
Beyer K, Eckermann O, Hompes S, Grabenhenrich L, Worm M. Anaphylaxis in an emergency setting - elicitors, therapy and incidence of severe allergic reactions. Allergy. 2012;67(11):1451-1456. DOI: 10.1111/all.12012
Munblit D, Treneva M, Korsunskiy I, Asmanov A, Pampura A, Warner JO. A national survey of Russian physicians’ knowledge of diagnosis and management of food-induced anaphylaxis. BMJ Open. 2017;7(7):e015901. DOI: 10.1136/bmjopen-2017-015901
Colleti J jr, De Carvalho WB. Anaphylaxis knowledge among pediatric intensivists in Brazil: a multicenter survey. J Intensive Care Med. 2017;32(10):593-596. DOI: 10.1177/0885066616659866
Drupad HS, Nagabushan H. Level of knowledge about anaphylaxis and its management among health care providers. Indian J Crit Care Med. 2015;19(7):412-415. DOI: 10.4103/0972-5229.160288
Sánchez J. Anaphylaxis. How often patients carry epinephrine in real life? Rev Alerg Mex. 2013;60(4):168-171.
Desjardins M, Clarke A, Alizadehfar R, Grenier D, Eisman H, Carr S, et al. Canadian allergists’ and nonallergists’ perception of epinephrine use and vaccination of persons with egg allergy. J Allergy Clin Immunol Pract. 2013;1(3):289-294. DOI: 10.1016/j.jaip.2013.03.006
Chooniedass R, Temple B, Becker A. Epinephrine use for anaphylaxis: too seldom, too late: current practices and guidelines in health care. Ann Allergy Asthma Immunol. 2017;119(2):108-110. DOI: 10.1016/j.anai.2017.06.004
Lieberman JA, Lieberman P, Wang J. Allergists’ opinions on anaphylaxis and epinephrine administration-a case-based survey. J Allergy Clin Immunol Pract. 2018;6(3):1075-1077. DOI: 10.1016/j.jaip.2017.11.031

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