Background:
Anaphylaxis is an acute-onset, life-threatening, systemic hypersensitivity reaction. The acute reaction occurs due to a permanently immunologically altered response, which can result in ...mild to severe reactions and, in isolated cases, to fatal reactions upon allergen contact. The avoidance strategies required lifelong in affected individuals significantly impair quality of life.
Objective and methods:
An expert analysis of the supportive care situation of anaphylaxis patients.
Results:
The trigger of the reaction — mostly food, insect venom, or drugs — can normally be identified by means of allergy diagnostics. However, allergy workups unfortunately are not always performed in anaphylaxis patients. Unequivocal diagnosis and/or causal classification of the trigger is not always easy, particularly in the presence of summation factors, such as physical exertion or the use of analgesics or alcohol. Complex cases present too rarely in allergy centers with appropriate experience. Following anaphylaxis patients are given guidance on allergen avoidance and after obligatory instruction from a medical expert, receive a prescription for an emergency self-medication kit. However, studies show that allergen avoidance often fails and patient self-medication is frequently not performed. Therefore, the German working group on anaphylaxis training and education (Arbeitsgemeinschaft Anaphylaxie Training und Education, AGATE) formulated a structured written interdisciplinary educational training program that is currently used in 24 registered centers in Germany. In a multicenter study using control groups, the anaphylaxis training program showed significant efficacy in terms of practical emergency management and reduced anxiety. The nationwide implementation of the training program and cost-coverage by statutory health insurances appear reasonable given the potentially life-threatening nature of this disease. Since statutory health insurances have not guaranteed cost-coverage to date, it is not possible to offer the training program to all patients in need.
Conclusion:
Subject to region and center, there are good treatment options for anaphylaxis patients in Germany. However, these options are not always sufficiently implemented.
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