Children, Elderly, Athletes and Pregnant Women Require Different Care For Allergies

Treatment Guidelines Developed by a Conference Convened by the Office of Continuing Medical Education, UCLA School of Medicine

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LOS ANGELES, Feb. 28,1996/ -- When it comes to allergy sufferers, all people are not the same. Children, the elderly, athletes and pregnant women have been identified as groups requiring different management and care, according to newly released treatment guidelines for allergic rhinitis, developed at a consensus conference convened by the Office of Continuing Medical Education, UCLA School of Medicine.

The guidelines, which provide physicians with recommended therapies for treating these groups, indicate that genetic and environmental factors may provoke or worse the symptoms of allergic rhinitis in each group. For instance, if one parent has allergies, there is a 50% chance the child will have allergies. Allergies may also be more common in children who were formula-fed, had a low birthweight or were exposed to dogs, cats and/or tobacco smoke early in life. In addition, infants exposed to high levels of house dust mites during their first year of life have been shown to have a five-fold increased incidence of asthma.

In athletes, physical exercise initially is associated with opening of the nasal passages. In some, a rebound congestion of a longer duration can occur which can impair performance. In women, allergic rhinitis symptoms may worsen during pregnancy. While fewer factors provoke rhinitis in the elderly, treatment needs to be more tailored due to slower metabolism and the potential for side effects. Also, this population is more likely to be taking multiple medications, including over-the-counter medications, and therefore runs a greater risk of drug interactions than most other patients.

"Because each of these groups has very special needs, their management and treatment needs to be individualized," said Sheldon Spector, M.D., clinical professor of medicine, UCLA School of Medicine. "In young children, for example, medication dosage should be prescribed according to their size."

The guidelines indicate that for many patients, topical nasal steroids and antihistamines provide effective treatment. Based on studies showing that sedating antihistamines can cause drowsiness and have a negative impact on thought and function, the guidelines suggest the use of nonsedating agents which cause no more impairment than placebos. Some patients require a combination of agents to control their symptoms.

"Our hope is that the treatment guidelines will help reduce the long-term health complications and costs often associated with allergies, including associated chronic respiratory disorders such as asthma, sinusitis and respiratory infections," said Spector.

To identify individual patient needs, the guidelines include a Patient Evaluation Form. This interactive tool asks patients to track their symptoms, catalogue their family history of allergies and describe the effects of allergies on daily life.

"We are confident that the patient evaluation form will serve as an effective tool to involve patients in their healthcare and to assist physicians in tailoring treatment plans," said Eli O. Meltzer, M.D., clinical professor of pediatrics, University of California, San Diego. "Our goal is to improve patient compliance with appropriate therapies and reduce dollars spent on ineffective treatment."

A free brochure will be made available to consumers through their physicians' offices. The brochure highlights the treatment guidelines and includes the tear-off patient evaluation form.

The guidelines were developed at a consensus conference convened by the Office of Continuing Medical Education, UCLA School of Medicine and supported by an unrestricted educational grant from Schering-Plough Corporation.

CONTACT: Jacquie Michels of UCLA Health Sciences Communications, 310-206-1960; or Barri Winiarski of Edelman Medical, 212-704-8186