Significant Educational Gaps in Allergy Research Recorded in Europe

Martha Cabrera, PhD

A recent position paper suggested that there were significant gaps in the management of allergic conditions from general practitioners in Europe.

Investigators led by Martha Cabrera, PhD, Hospital los Madronos, Brunete, Spain, believed that more comprehensive allergy training should be enacted to address that training and educational inadequacies.

Though important advances had been made in the understanding of allergic diseases, the investigators noted that few medical school faculties consider allergology to be a subject area of serious interest.

As such, undergrad training had been largely insufficient, which was of particular concern given that 30% of the European population suffer from allergic disease with increasing prevalence.

Recently, the World Allergy Organization (WAO) issued a warning regarding knowledge gaps in the field of allergy management. Though some European scientific allergy societies had developed medical education programs to help with the issue, these educational gaps still exist.

Cabrera and colleagues explored the specific educational needs of a cohort of European general practitioners with regards to allergy training so future educational initiatives may better support the delivery of allergy services in primary care.

The Methods

During the study, a structured electronic questionnaire developed by The European Academy of Allergy and Clinical Immunology (EAACI) and the Working Group on Primary Care (WGPC) was issued to by primary care providers across 8 European countries from September 2019 to November 2019.

The questionnaire revolved was comprised of questions involving demographic parameters, professional qualification, employment type, level of confidence regarding competencies for diagnosis and treatment of allergic diseases, and referral of patients to allergist and preferred method of learning and assessment.

Responders were tasked with rating their confidence across the different areas of allergic disease management specific in the questionnaire on a scale of 1 to 5, with 5 being the most confident.

A total of 687 responses were received, 99.3% of which were from Europe.

The Findings

Cabrera and investigators recorded a special interest in allergy of 22%, yet 78% of those responders reported working 0-8 hours a week in that field.

Additionally, A majority of responders (64.7%, n=446) reported seeing between 0-10 patients per week whose main complaint was an allergic problem, and70.3%, (n=484) of responders reported that less than half their patients visited a pharmacy prior to visiting them for their allergy within the previously year.

A total of 127 (18.4%) responders reported having no education associated with allergy. However, responses to this question varied greatly between countries.

The highest awareness of general practitioner guidelines were reported from the Netherlands (89.5%), with the lowest among those being from Italy (24.1%).

Regarding different allergic conditions, responders felt most confident to manage rhinitis/asthma (83.3%), and least confident to manage occupational allergy (23.5%). Between 47.3% and 83.8% of responders did not feel confident in understanding sensitization, cross-reactivity, basic mechanisms, immunotherapy and environmental control measures.

Lastly, there were statistically significant differences across age groups regarding educational preferences, with responders aged 35-54 years old preferring e-learning over traditional learning.

Regardless of preferences, Cabrera and investigators believed their data to suggested a need for skills training and educational need across Europe.

“If, as has been acknowledged, the time to address the significant gaps in the management of allergic conditions is now critical, the solutions must involve primary care providers, who are currently unsupported and sub-optimally equipped to address these challenges,” the investigators wrote. “A strategy for primary care providers in the management of allergic conditions is needed now.”

The paper, “Current allergy educational needs in primary care. Results of the EAACI working group on primary care survey exploring the confidence to manage and the opportunity to refer patients with allergy,” was published online in the European Journal of Allergy and Clinical Immunology.