乌鸦传媒視頻

A 5-principle patient charter may improve care for patients with chronic urticaria (CU), according to a commentary published in a recent issue of Advances in Therapy.¹

Chronic urticaria: a global burden

CU has been estimated to affect as much as 1.4% of the world鈥檚 population.^1,2 It can occur spontaneously or in response to specific triggers. Symptoms, which can impact patients鈥� mental health and quality of life, include the presence of itchy, sometimes painful, hives and/or angioedema that lasts for more than 6 weeks.¹ Recently updated treatment guidelines for CU, while providing timely, high-quality treatment advice, haven鈥檛 fully elucidated the role of patient-physician communication, which is also crucial for better outcomes.^1,3

鈥淲e must do more than the current approach of antihistamines and steroids in treating CU. We now better understand the underlying inflammatory pathways and have a greater opportunity to interrupt the cycle of flares,鈥� Tonya Winders, MBA, one of the commentary鈥檚 authors and president of the Global Allergy and Airways Patient Platform (GAAPP), told 乌鸦传媒視頻. 鈥淧eople living with this condition want to better control the unpredictable symptoms and debilitating impacts of CU on their physical, mental, and emotional health.鈥�

The new charter, Winders says, aims to outline these aspirations and calls on policymakers to 鈥渆levate this condition.鈥�

Details of the charter

This 5-principle charter was authored collaboratively by patients, clinicians, advocates, and pharmaceutical industry representatives, all selected by the Global Allergy and Asthma Excellence Network鈥檚 (GA2LEN) Urticaria Centers of Reference and Excellence (UCARE) program, along with representatives from GAAPP.¹

鈥淐U has been unrecognized, and the patient voice not heard or understood fully in the medical literature,鈥� Winders says. 鈥淭he patient charter is the first of its kind to be authored by patients, advocates, and medical experts in the field.鈥� Here are the details:

Principle 1: 鈥淚 deserve an accurate and timely diagnosis of my CU.鈥� The authors note that delays in diagnosis of CU are common because patients and providers often believe it will resolve on its own. Additionally, symptoms are frequently not present during healthcare encounters. This first principle is therefore designed to prevent these delays. The authors note that the 2022 international urticaria guideline algorithm can be used as an aid for timely diagnosis.^1,3

Principle 2: 鈥淚 deserve access to specialty care for my CU.鈥� Primary healthcare providers and emergency department physicians are often the initial contacts for patients with CU.¹ Surveys reveal that many primary healthcare providers feel inadequately informed about CU, leading to delayed diagnoses and treatment, underscoring the importance of patient access to specialized care for effective and appropriate treatment.¹ The GA2LEN/UCARE network consists of practices that have met GA2LEN requirements for referral, allowing it to serve as a specialty care resource for providers treating patients with CU.^1,4

Principle 3: 鈥�I deserve access to innovative treatments that reduce the burden of CU on my daily life.鈥� Antihistamines are ineffective in nearly half of CU patients.^1,5 Principle 3 was included to remind clinicians to consider lesser-known treatments.^1,5

Principle 4: 鈥淚 deserve to be free of unnecessary treatment-related side effects during the management of my CU.鈥� First-generation antihistamines, once commonly used for CU, are now discouraged due to side effects like drowsiness and impaired motor responses, which can lead to accidents.¹ Second-generation antihistamines are preferred for their limited sedating effects, but caution is still advised, especially at higher doses. Oral corticosteroids (OCS) are used for severe CU flare-ups, but their long-term use is discouraged due to risks such as diabetes and cardiovascular issues, highlighting the need for optimizing non-OCS treatments. Principle 4 was included to ensure that individuals receive only medications that are necessary and in doses that minimize side effects.

Principle 5: 鈥淚 expect a holistic treatment approach to address all the components of my life impacted by CU.鈥� The authors note that effective management of CU should aim to alleviate symptoms and improve overall quality of life, and involve shared decision-making between patients, families, and healthcare providers. In addition, patient advocacy groups and professional organizations can provide reliable information and support, helping patients connect and cope with the challenges of living with CU.

A communication tool for patients and providers

There are additional resources available to aid clinicians in achieving the principles laid out in the charter. 鈥淭he GA2LEN network has established the latest clinical guidelines and treatment algorithms consistent with this charter,鈥� Winders notes, adding that 鈥淒r. Marcus Maurer is the foremost global expert in CU, and he has a number of podcasts that also highlight how to ensure optimal care for those living with CU.鈥�

One of the goals of the new charter is to serve as a communication tool for CU patients and their healthcare providers. 鈥淚t helps clinicians better understand what matters most to patients,鈥� says Winders. 鈥淚t follows a logical patient journey and highlights where current barriers exist.鈥�

Winders believes more research is needed to further optimize care for CU patients. 鈥淲e also need more health economics and outcomes data to ensure we鈥檙e allocating resources to the treatments with the most positive outcomes for patients,鈥� she says.

Published: February 28, 2024