Improving Allergen Immunotherapy Assessment and Follow-up Utilizing a Screening Tool

Abstract

Problem & Purpose: Allergen immunotherapy (AIT) is an effective treatment for environmental allergies and/or allergic asthma involving the administration of subcutaneous injections at regular intervals. Treatment guidelines recommend the routine use of questionnaires and annual follow-up visits to monitor patients’ symptoms, AIT tolerance and efficacy, and guide overall treatment plans. Poor follow-up rates and a lack of routine assessment with screening tools were identified at a suburban Maryland allergy and asthma specialty care clinic. Methods: A pre-screening tool was administered every 4 to 6 weeks prior to AIT injections. The screening included health questions and validated assessments of allergy and/or asthma symptom severity and disease control. Individualized patient follow-up plans were determined based on screening results and evidenced based improvements were also made to patient educational materials, and AIT administration records. Results: Over 14-weeks, 85 adult patients completed a total of 204 screenings. The overall screening completion rate was 86.1%, with 41.2% of screenings identified as positive, and timely appointments scheduled for 66.7% of positive screenings. Overall compliance with AIT follow-up within 12 months improved significantly, from a baseline of 62.35% (n=53), to 98.82% (n=84) over the course of the project (p>0.001). Conclusions: Significant improvements in AIT patient assessment and provider follow-ups were noted during the course of this quality improvement DNP project. These improvements demonstrate that the quality improvement interventions were successful and over time may improve the overall disease management and health outcomes of AIT patients. demonstrating over time that patients may improve their overall disease management and health outcomes.