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GPs not following asthma guidelines in U.K., study says
Some general practitioners in the United Kingdom are prescribing syrups or drugs for asthma that are discouraged by British Thoracic Society guidelines, according to a study in Archives of Disease in Childhood. Australian researchers from Sydney Children's Hospital analyzed U.K. prescribing data from 2000 to 2006. They found that while bronchodilator syrup prescriptions dropped by 60 percent during the study period, doctors still wrote 121,000 prescriptions in 2006. In addition, the total number of long-acting beta agonist prescriptions nearly doubled despite the guidelines’ concern about their effectiveness in children. The percentage of prescriptions for combination inhalers, containing steroid and a long-acting beta agonist, also rose seven-fold, despite BTS guidelines recommending combination inhalers be used only when appropriate dose steroid inhalers fail to control the asthma adequately.

Exercise-induced asthma rate high among college athletes
One in three college athletes may have exercise-induced asthma, despite no previous history of the disease, according to a study in Medicine & Science in Sports & Exercise.Scientists at Ohio State University studied 107 athletes, using eucapnic voluntary hyperpnea testing. The test challenges or stresses the lungs by making the subject hyperventilate, then measuring his or her lung function to determine if it decreases from the stress, mimicking the expected changes in exercise-induced asthma. Forty-two tested positive for exercise-induced asthma, 36 of which had no previous history of asthma. Researchers found that neither gender nor the sport they participated in affected the likelihood of testing positive.

Study: Asthma education may be insufficient in U.S.
How much asthma education you get depends on your gender, age, race, and health insurance status, according to a study in Morbidity and Mortality Weekly Report. The study also suggests that a large percentage of young people and adults with asthma do not have the education they need to manage their disease effectively and control their asthma symptoms. Researchers from the U.S. Centers for Disease Control and Prevention in Atlanta analyzed data from the 2003 National Health Interview Survey (NHIS) questions designed to reflect clinical best practices for asthma, as well as from a supplement regarding components of effective asthma self-management. The survey included 43,101 subjects. From the sample, the CDC estimates that about 8.5 percent of U.S. youths younger than 17 and 6.4 percent of U.S. adults had current asthma in 2003. Among youths in the study, 40 percent had never had an asthma management plan and 78 percent had been taught how to respond to an asthma attack. Among adults, 65 percent had been taught how to respond to an asthma attack.

A message from Dr. Richard Gower
Allergist Marketing Task Force Chair

We all recognize the growing challenges that our specialty faces: Patients’ preference to self-medicate, avoidance of specialists, and physicians who are not allergists providing substandard allergy treatment. These all stem from deficits in public awareness and perceptions. Overall, there is far too little understanding of allergic and immunologic diseases and the real relief that allergists can provide.

ACAAI response: The College is preparing to launch a national public education campaign based on consumer research and analysis. We are developing tailored strategies to address these issues and envision a campaign to make our specialty better known and understood by those who need our help.

How we got here: The need for the campaign and our response have not materialized overnight. At the 2006 Annual Meeting, the College formed a marketing task force to look at the specialty’s challenges and determine how we can better explain the benefits of allergist care. The task force has met regularly to determine how to communicate our messages. We have selected public relations and marketing partners to help us develop the approach we will take.

Enter PCI and Reingold: We have selected Public Communications Inc. (PCI) and Reingold Inc. to help us with the necessary research and development of strategies. Together we are conducting careful market research that focuses on current consumer knowledge and perceptions of allergists to develop our positioning and “branding” for our specialty. We will solicit additional ideas and opinions through a College member survey.

After research is completed, we plan to launch a carefully crafted national marketing campaign using clear, positive messages, including public education and advertising, tool kits for members, and partnerships with other key groups.

Anticipated results: We are taking major steps to increase awareness, correct deficits in understanding, and improve appreciation for the role of allergists/immunologists in health care. With your help and active participation, more patients will gain access to the care we provide.

Stay tuned for more information on this important initiative. We appreciate your participation and comments.

Sincerely,

Richard G. Gower
ACAAI Vice President
Allergist Marketing Task Force Chair

Indoor environment, food allergy programs
bookends for ACAAI Annual Meeting in Dallas
The full-day “Healthy Indoor Environment Conference,” Thursday, Nov. 8, and the half-day “Food For Thought” plenary session, Wednesday, Nov. 14, will be bookends for the ACAAI Annual Meeting in Dallas. Each program will cover practical information you and your patients can implement immediately.

Healthy Indoor Environment – Nov. 8
Attendees will look at the ins and outs of healthy buildings and nonfunctional buildings, including building-related health effects; animal, dust mites and other bug allergens; and particulates and other irritants. Special guest speakers include Jeffrey May, author of My House is Killing Me! and other books, and Thomas Kelly, director, Office of Regulatory Management and Information of the Environmental Protection Agency. Afternoon breakout sessions will cover environmental measurement, sampling and interpreting reports; effective methods of remediation; and recommendations for patients. The conference is supported by an educational grant from Clorox.

Food For Thought – Nov. 14
Part 1 will present existing data and a rational approach to prevention strategies for food allergy; the Lester Mittelstaedt Lecture on “Prediction of Future Tolerance to IgE-Mediated Cow Milk Allergies;” and “You Can Have Allergy to Food and Eat it Too” covering cross-reactivity, differences in allergenicity in different components of foods, and food processing. Part II will include discussions on eosinophilic GI disorders; oral tolerance; and current and potential therapies.

Plan to come for the beginning and stay through the end. Join your colleagues for the ACAAI Annual Meeting at the Gaylord Texan Resort and Conference Center.

Online registration fast and easy. You can also view the preliminary program online and select from a variety of Workshops and Meet the Professor Breakfasts tailored to your needs.

Wynonna Judd headlines Fundraising Dinner
World-renowned vocalist and entertainer Wynonna Judd will perform at the 2007 Annual Meeting Fundraising Dinner, Sunday evening, Nov. 11, at the Gaylord Texan Resort.

Wynonna touches the hearts and souls of many with her powerful, soulful voice and presence. She has earned 20 No. 1 hits and a multitude of gold and platinum records. She won the top Female Vocalist award from the Academy of Country Music and is scheduled to release her seventh studio album this year.

Prior to her first solo record deal in 1992, Wynonna shard one of the most celebrated success stories in country music history with her mother, Naomi, as a member of The Judds. In just six years, they sold more than 20 million records worldwide and won more than 60 industry awards, including five Grammys, nine Country Music Association Awards and eight Billboard Music Awards.

Net proceeds from the event will be donated to the ACAAI Foundation to support The Consortium on Children’s Asthma Camps, Scholars Return Programs and Young Faculty Support Awards.

The fundraising program includes a reception, dinner and performance. The event is supported in part by grants from: Alcon Laboratories Inc., AstraZeneca LP, Sepracor Inc., and Teva Specialty Pharmaceuticals. Buy your tickets when you register for the ACAAI Annual Meeting.

ACAAI, FAAN conduct school nurse workshop in Dallas
The College is partnering with the Food Allergy & Anaphylaxis Network (FAAN) to educate school nurses on food allergy management at a workshop held Monday, Nov. 12, in conjunction with the ACAAI Annual Meeting in Dallas.

“In our experience, school nurses continue to struggle with how to manage the ever increasing number of food-allergic students for which they are responsible,” said Anne Murnoz-Furlong, founder and CEO of FAAN. “Many of them are reinventing the wheel because they don’t know what tools or resources are available to them. Some prepare comprehensive school-wide awareness plans, others focus solely on the student’s class. In all cases, they welcome information and guidance.”

The workshop, supported in part by an educational grant from Verus Pharmaceuticals, is spearheaded by the College’s Public Education Committee.

“The wealth of expertise and resources available at the College Annual Meetings gives us a unique opportunity for conducting outreach programs to educate the community in our host cities,” said Dr. A. M. Aminian, chair of the Public Education Committee. “We are hoping this joint venture with FAAN for school nurses will not only be continued at future meetings, but expanded to include other allergic diseases.”

Members in the spotlight
Dr. Linda S. Cox, Ft. Lauderdale, Fla., received official notification of her appointment to the FDA Advisory Board on Allergenic Products, following her nomination by the College and AAAAI. The Board reviews and evaluates available data concerning the safety, effectiveness, and adequacy of labeling of marketed and investigational allergenic biological products or materials that are administered to humans for the diagnosis, prevention, or treatment of allergies and allergic disease. It also oversees: the affirmation or revocation of biological product licenses; the safety, effectiveness, and labeling of the products; clinical and laboratory studies of such products; amendments or revisions to regulations governing the manufacture, testing and licensing of allergenic biological products; and the quality and relevance of FDA's research programs.

Have you written a new book? Have you won a prestigious award? Are you doing something that ACAAI members would really find interesting? Submit notable achievements and read about those of your peers in ACAAI eNews. Please e-mail member news notices to joannfaber@acaai.org.

Welcome to the AMA Corner prepared by Dr. Alnoor A. Malick, ACAAI Delegate to the AMA House of Delegates, to keep you abreast of important AMA news and developments impacting allergy-immunology.

Vote for ACAAI representation in AMA policymaking
With 109 national medical specialty societies included in the AMA House of Delegates, it’s important for physicians to ensure that their specialty societies are as well-represented in the AMA’s policymaking process as possible.

To enhance physicians’ opportunities to shape the AMA’s national health care policies and advocacy strategies, the AMA has developed an online ballot where physicians can vote for the specialty society that best represents them. For every 1,000 votes received, specialties receive one additional delegate in the House. Each national medical specialty society member is allowed one vote. Designate ACAAI as your representative organization on the AMA Web site.

Register for AMA audio conference on
hiring, retaining top-performing employees
The AMA’s Office of Group and Faculty Practice will host a 90-minute audio conference about hiring and retaining top-performing employees for better customer service and patient care. The session, scheduled for Oct. 4, will cover assessing the impact of having the right staff, interviewing to hire the best talent, keeping good people after they are hired and maintaining harmony. Featured faculty is from the Coker Group, a nationally recognized consulting firm that specializes in practice management. The registration fee for AMA members is $35 ($75 for nonmembers) and includes a free supplemental publication from the AMA.

Physicians should review CIGNA contracts
With the CIGNA Multi-district Litigation (MDL) class action lawsuit agreement protections having expired Sept. 4, all physicians under contract with CIGNA should review their contracts and contact their provider representatives to determine how they may be affected.

In addition, CIGNA has indicated that it might no longer recognize a patient’s assignment of benefits to a non-contracted physician. The AMA encourages all non-contracted physicians to discuss and collect, when appropriate, the patient’s financial responsibility before the delivery of patient care.

Managed Care Advisory Group LLC (MCAG) continues to pursue CIGNA for payment of claims filed under the settlement in 2005. MCAG has sued CIGNA for recovery of the claims and has agreed to binding arbitration to resolve outstanding disputes on those claims. As of June, MCAG re-filed all 700,000 previously submitted claims under an order issued by the judge arbitrator, and CIGNA is processing those claims for payment. MCAG expects resolution of all outstanding claims by the end of the year. Visit www.hmosettlements.com to download the complete settlement.

The AMA encourages all physicians to learn about the protections the MDL class action settlements offer physicians. Physicians may consider filing a compliance dispute — a free, simple enforcement process — if prohibited clauses are contained in a contract submitted by the settling health insurer, or if the settling health insurer fails to adhere to the terms of its settlement. Physicians are encouraged to hold the settling health plans accountable to their respective settlements. View www.ama-assn.org/ama/pub/category/12753.html to access a checklist of some key settlement terms and additional information on the other MDL settlements.

Board Review Corner
Welcome to the Board Review Corner prepared by Soo Kim-Delio, M.D., 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 “FIT Archive” link in the left column.

Review Questions: Chapter 9 of Pediatric Allergy: Principles & Practices, edited by Donald Y.M. Leung, et al. Review questions were written by Drs. Bret Haymore and Soo Hee Kim-Delio, Walter Reed Army Medical Center.

Copyright © 2007 American College of Allergy, Asthma & Immunology. All rights reserved.
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Do you have news, responses or opinions to share with us? Please e-mail the association office at enews@acaai.org