J ALLERGY CLIN IMMUNOL VOLUME 129, NUMBER 2
Allergy Training and Immunotherapy in Latin America: How Survey-Results Lead to a Regional Overview D. E. S. Larenas Linnemann1, M. Gomez2, G. Passalacqua3, S. N. Gonzalez Diaz4, V. H. Croce5, G. W. Canonica6, C. Baena Cagnani5; 1Hospital Medica Sur, Mexico, MEXICO, 2Centro Investigacion Medicina Respiratoria (CIMER-UCC), Salta, ARGENTINA, 3Allergy & Respiratory Diseases (DIMI), Universit Degli Studi Di Genova, Genoa, ITALY, 4 Latin American Society of Allergy, Asthma & Immunology, Monterrey, MEXICO, 5Centro Investigacion Medicina Respiratoria (CIMER-UCC), Cordoba, ARGENTINA, 6Allergy & Respiratory Diseases (DIMI), Universita Degli Studi Di Genova, Genoa, ITALY. RATIONALE: In May 2011 Latin American (LA) allergen experts met in Cordoba to discuss how allergy and immunotherapy can be improved in the region. The need for a situational sketch was expressed. METHODS: A questionnaire on allergy training, allergen immunotherapy, extracts and legislation was sent out to obtain an overview of the Latin American situation. Descriptive statistics were used. RESULTS: All 22questionnaires were returned (9 countries). Allergy training is at the third-level of medical care in 56% of the surveyed LA countries (after core-training of 2-3y internal medicine/pediatrics), at the second-level in 3 countries and completely lacking in one. Board certification with exam is mandatory in 3/9 countries; recertification being obtained without exam. Pediatric allergy training exists in two countries. Both sublingual (SLIT drops) and subcutaneous (SCIT) immunotherapy are administered in all countries, from the mean age of 3yrs onward (range 1-5yrs). IT can be managed by non-allergists in 7/9 countries. Mixed extracts are used with 3-5 allergens/vial (median); all countries have bacterial vaccine. SCIT extracts come from US and European (89%) and 56% local providers. SLIT extracts are almost exclusively from Europe, but in 3 countries with local SLIT extracts. There is rudimentary regulation concerning extract potency in two countries. IT is financed by private patients (100% of countries), insurance companies (56%), the social security system (33%) and third level governmental hospitals (11%). Three countries published on adverse events and three have their own ITguidelines. CONCLUSIONS: A clearer LA picture has been obtained of where and how to improve allergy training and immunotherapy.
Pharmacists Understanding of Patient Education on Inhalers J. Jeong1, C. Park2; 1Ilsan Paik Hospital, Goyang, REPUBLIC OF KOREA, 2Haeundae Paik Hospital, Busan, REPUBLIC OF KOREA. RATIONALE: Optimal asthma management requires intervention by a number of health care professionals, including community pharmacists. The aim of this study was to evaluate the attitudes of community pharmacists towards asthma inhalers and the current state of inhaler education. METHODS: A descriptive survey through self-administered questionnaire was conducted among community pharmacists who attended education program. RESULTS: Most pharmacists indicated that they did not learn about inhalation therapy and inhaler devices during undergraduate course (67.7% and 96.8%). Only 40.4% of pharmacists reported they educated asthma patients about inhaler methods. Pharmacists perceived that there were not enough time to educate patients who use inhaler devices. Also they answered lack of their experiences about inhalers and training materials as main obstacles. CONCLUSIONS: Although they had few opportunities to learn about inhalation therapy and inhaler devices, many pharmacists reported that they frequently educate patients. It is mandatory to develop and implement the effective undergraduate education programs for community pharmacists. And rather than limiting their action to dispensing drugs, community pharmacists can also become involved in asthma education.
A Scintigraphy Study Evaluating The Nasal Deposition And Retention Of Ciclesonide Hydrofluoroalkane Nasal Aerosol And Mometasone Furoate Aqueous Nasal Spray In Patients With Perennial Allergic Rhinitis J. Karafilidis, B. Wang; Sunovion Pharmaceuticals, Marlborough, MA. RATIONALE: A hydrofluoroalkane nasal aerosol solution formulation of ciclesonide (CIC-HFA) is currently in development for allergic rhinitis. The objective of this study was to compare the retention within the nasal cavity, nasal run-out and post-nasal drip of CIC-HFA and mometasone furoate aqueous nasal spray (MFNS) following intranasal administration. METHODS: In this phase I, open-label, 2-period, non-randomized scintigraphy study, patients 18-65 years of age with symptomatic perennial allergic rhinitis (N514) received a single dose of radiolabelled 148mg CIC-HFA (1 actuation/nostril, 74 mg/actuation contain_5 MBq 99mTc in 2 actuations) via a metered dose inhaler, followed ing < by a washout period of 72 hours, then a single dose of radiolabelled _5 200mg MFNS (2 actuations/nostril, 50 mg/actuation containing < MBq 99mTc in 4 actuations) via a pump spray. Deposition of radioactivity was quantitated by scintigraphy (% of delivered dose) in the nasal cavity, nasopharynx, and on nasal wipes at 2, 4, 6, 8, and 10 minutes post-administration. RESULTS: All 14 patients completed the study. Deposition & retention in the nasal cavity was greater with CIC-HFA (2 min599.48%, 10 min580.81% respectively) than MFNS (2 min586.28%, 10 min554.09% respectively). Less nasal run-out (wipes:2 min50.49%, 10 min51.60% for CIC-HFA; 2 min512.15%, 10 min513.74% for MFNS) and post-nasal drip (nasopharynx:2 min50.03%, 10 min517.59% for CIC-HFA; 2 min51.58%, 10 min532.19% for MFNS) was also observed with CIC-HFA. CONCLUSIONS: In this scintigraphic deposition study, greater deposition & retention in the nasal cavity and less post-nasal drip was observed in the first 10 minutes following administration of CIC-HFA than of MFNS.