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FDA calls for stronger warnings on LABAs
Regulators from the U.S. Food and Drug Administration recently released a Public Health Advisory concerning the long-acting beta-2 adrenergic agonists (LABA), salmeterol and formoterol. The FDA asked manufacturers to "update their existing product labels with new warnings and [to provide] a Medication Guide for patients to alert health care professionals and patients that these medicines may increase the chance of severe asthma episodes, and death when those episodes occur." Salmeterol is marketed in the United States by GlaxoSmithKline as Serevent Diskus, and as a component of the combination product, Advair Diskus. Formoterol is marketed in the United States by Schering-Plough as Foradil Aerolizer. 
Information sheets for patients and health care professionals:  

Patient survey shows allergists provide better asthma care
Asthma patients who receive care from an allergist report better control of their disease than those who are treated by a primary-care doctor, according to a study by Kaiser-Permanente in San Diego. Researchers surveyed nearly 3,600 people with persistent asthma. Of the 3,600, 47 percent said they received regular asthma care from a primary-care doctor, 25 percent from an allergist, and 5.5 percent from a pulmonologist. Another 19.4 percent said they had no regular source of asthma care. Among other things, patients treated by an allergist reported fewer asthma control problems, less severe asthma symptoms, and better overall general health than patients treated by a primary-care doctor. They also were less likely to be hospitalized or require unscheduled doctor visits.

Study: Asthma severity stays same during school years
Children with asthma symptoms at 6 years old tend to have the same level of lung functioning during the next 10 years, according to a study in the American Journal of Critical Care Medicine. Researchers from Tucson’s University of Arizona Health Sciences Center and Denver’s National Jewish Medical and Research Center and University of Colorado Health Sciences Center studied 826 children, examining parent questionnaires and lung function tests. While the children with asthma symptoms remained stable, only about 75 percent of those who had either no wheezing or wheezing only before 3 years old continued symptom-free.   

iHealth services are sure-fire practice differentiators
As an ACAAI member, you have access to a practice Web site that has recently been upgraded with tools that can help you increase your practice revenue, improve patient satisfaction, reduce your liability and improve your practice marketing.

By using Medem Inc.’s iHealth Services, you can create a practice Web site, have your patients complete a secure online personal health record—the iHealthRecord—communicate with them through Online Consultation and Secure Messaging tools and provide your patients with health education and adherence programs including asthma and other allergic diseases.

Beginning in 2006, ACAAI members will be able to continue utilizing iHealth Services for just $16.25 per month---a $100 annual savings because the College is a founding member of Medem.

And, if you have 300 of your patients sign up for an iHealthRecord via your practice Web site in 2006 OR perform at least one charged-for Online Consultation on average per week during the 2006 calendar year, your 2006 fees will be credited to your 2007 subscription.

“My Web site is a great tool for efficient appointment scheduling and prescription refills, decreasing the need for time-consuming phone calls,” said Dr. J. Allen Meadows, ACAAI representative to the Medem Board. “I also send reminders to my patients about influenza immunizations, changes in my allergy shot schedule, and I use the site to promote new services. The Web site offers an easy, economical alternative to calling or mailing patients.

“An increasing number of my patients are computer savvy, and choose me because of the online services that I offer them through Medem. These tools give me a competitive edge, and at only $16.25 per month, it’s a bargain, and a great benefit of College membership,” Dr. Meadows said.

Log on or create your Web site to activate these services. If you have any questions, feel free to contact Medem’s Member Services at info@medem.com or 1-877-926-3336.

Guidance offered on self-administration of medication at school
As of October, 46 states had enacted self-carry laws for albuterol and 35 for epinephrine, according to the Asthma and Allergy Network/Mothers of Asthmatics Web site.

All schools must abide by state laws and policies related to permitting students to carry and self-administer asthma inhalers and epinephrine auto-injectors.

The American Academy of Pediatrics worked with the National Asthma Education and Prevention Program (NAEPP), the Centers for Disease Control and Prevention, the American School Health Association, the National Association of School Nurses and other organizations to develop guidance for physicians and other health care clinicians who prescribe emergency medications. The guidance includes a list of factors to consider when determining when to entrust and encourage a student with diagnosed asthma and/or anaphylaxis to carry and self-administer prescribed emergency medications at school. The guidance, called "When Should Students with Asthma or Allergies Carry and Self-Administer Emergency Medications at School? Guidance for Health Care Providers Who Prescribe Emergency Medications," is available online.

Allergy Practice Tip: Build Up New Physicians
Advice from The Patient-Centered Allergy Practice
When a new physician starts at your practice, have existing physicians introduce him or her to established patients and transfer their care. Instruct schedulers to fill the new physician’s schedule. Too often, young physicians have half-empty schedules simply because of long-established scheduling patterns. Switch it up. For more advice, visit www.PatientCenteredAllergyPractice.com

These tips are drawn The Patient-Centered Allergy Practice, a CME Series in Practice Management, supported through an educational grant from sanofi-aventis Group and endorsed by the American College of Allergy, Asthma & Immunology.

ACAAI FIT Bowl champions Drs. Jason Perry (left) and Christina Mazzoni with ACAAI President Dr. William K. Dolen.

Immunology Review Corner
Welcome to the Board Review Corner prepared by Dr. Karla L. Davis, Senior Representative of ACAAI’s fellows-in-training (FITs) to the Board of Regents. The Board Review Corner is your chance to test your Board preparedness.

To refer to a previous Board Review Corner, click the “Archive” link in the left column.

Chapter 58 of the 6th edition of Middleton’s Allergy Principles and Practice, edited by N. Franklin Adkinson, et al. Review questions were written by Drs. Thao Tran and Karla Davis.