Recorded presentation

Shawn K. Bowen, MD¹, Roy Grant², Amy Rowe, PNP¹, Alan Shapiro, MD³, and Candice Manzano, BA¹. (1) Division of Community Pediatrics, Childhood Asthma Initiative, The Children's Hospital at Montefiore/AECOM, 317 East 64th Street, New York, NY 10021, 212-535-9779, sbowen@montefiore.org, (2) The Children's Health Fund, 317 East 64th Street, New York, NY 10021, (3) South Bronx Health Center for Children and Families, 871 Prospect Avenue, Bronx, NY 10459

Background: Asthma prevalence rates for children in the Bronx are the highest of any borough in NYC. Housing conditions in the inner city are often sub-standard. Dust mites, cockroaches and other indoor allergens trigger asthma exacerbations. Parents are unfamiliar with the link between asthma and allergy. The National Heart Lung and Blood Institute (NHLBI) recommends that standard asthma care include an assessment of environmental triggers. These are performed infrequently in the primary care setting. Objective: To explore potential links between asthma morbidity and allergen sensitization. Design/Methods: Retrospective analysis of 98 asthma and allergy assessments from patients, ages 2-19 followed in a South Bronx primary care clinic. Results: Seventy-five percent of patients were skin test sensitive to at least one allergen. Fifty percent of patients were positive for cockroach allergen, 45% for dust mites. The parents of 80% of patients sensitive to roach did not report roach as a trigger. Similarly, dust mite was not reported as a trigger for 60% of patients sensitive to dust mite. Patients sensitive to dust mite were significantly more likely to have been hospitalized in the preceding 12 months (14.6 % compared to 1.7% ; p< 05). Conclusions: Identification of allergic triggers by skin testing can guide pharmacotherapy as well as influence families to initiate avoidance strategies. Skin testing in the primary care setting has the potential to reduce morbidity and health care costs in high utilization populations.

Funded by: Picower Foundation, Schering-Plough

Learning Objectives: At the end of this presentation, participants will

• better understand the contributory role of allergic sensitization to asthma severity and movidity;
• have new ideas about how to integrate allergy testing in primary care-based asthma treatment;
• better understand the need to educate caregivers of children with asthma about their child's allergic triggers

Keywords: Asthma, Health Care Delivery

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation