Allergy testing in asthmatics and severe asthmatics: habits among respiratory physicians in Belgium

Abstract

Background: In patients with asthma, there is currently no clear consensus which tests should be performed to confirm a diagnosis of allergy.

Aims and Objectives: We aimed to gain insights in the decision making in allergy testing in patients with asthma in Belgium.

Methods: Twenty-five Belgian respiratory physicians were interviewed by means of a questionnaire.

Results: A majority (60%) of the respondents indicated to start, during initial allergic work-up, with skin prick testing (SPT), rather than testing for specific serum IgE (sIgE). Dermatophagoides pteronyssinus (Der p), birch, grass pollen mixture, cat epithelium, Aspergillus, Alternaria, dog epithelium, mugwort, plantago and Dermatophagoides farinae (Der f) were, in descending order, the most frequently performed SPT. When testing for sIgE, 64% of respondents indicated to start with a limited, fixed set of tests during initial allergy work-up, mainly due to reimbursement restrictions. Der p, grass pollen mixture, tree pollen mixture, mixture of fungi, birch, mixtures of herbs, mixture of pets, cat epithelium, Aspergillus fumigatus and Der f are, in descending order, the most frequently performed sIgE tests. When initial tests are negative, a majority (64%) of physicians considers performing additional testing, mainly guided by a history of specific exposures. Allergy testing is performed more frequently in patients with severe asthma compared to patients with asthma but in general, the choice of allergy tests does not differ between patients with asthma or severe asthma.

Conclusions: There is a large heterogeneity among Belgian respiratory physicians regarding decision making in allergy testing in patients with asthma.