Optimization of care for patients with hereditary angioedema living in rural areas.


Journal

Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology
ISSN: 1534-4436
Titre abrégé: Ann Allergy Asthma Immunol
Pays: United States
ID NLM: 9503580

Informations de publication

Date de publication:
05 2022
Historique:
received: 30 06 2021
revised: 21 09 2021
accepted: 28 09 2021
pubmed: 11 10 2021
medline: 4 5 2022
entrez: 10 10 2021
Statut: ppublish

Résumé

People living in rural areas of the United States experience greater health inequality than individuals residing in urban or suburban locations and encounter several barriers to obtaining optimal health care. Health disparities are compounded for patients with rare diseases such as hereditary angioedema (HAE), an autosomal dominant genetic disorder characterized by recurrent, severe abdominal pain and life-threatening oropharyngeal or laryngeal swelling. To explore the challenges of managing patients with HAE in rural areas and suggest possible improvements for optimizing care. PubMed was searched for articles on patient care management, treatment challenges, rural health, and HAE. Relevant articles were selected and reviewed. Challenges in managing HAE in the rural setting were identified, including obtaining a diagnosis of HAE, easy access to a physician with expertise in HAE, continuity of care, availability of telemedicine services, access to approved HAE therapies, patient education, and economic barriers to treatment. Ways to improve HAE patient care in rural areas include health care provider recognition of the patient with undiagnosed HAE, development of individualized management plans, expansion of telemedicine, effective care at the local level, appropriate access to HAE medication, and increased awareness of patient support and advocacy groups. For patients with HAE living in rural areas, optimal care is complicated by health disparities. Given the scarcity with which these topics have been covered in the literature to date, it is intended that this article will serve as the impetus for a range of further initiatives focused on improving access to care.

Sections du résumé

BACKGROUND
People living in rural areas of the United States experience greater health inequality than individuals residing in urban or suburban locations and encounter several barriers to obtaining optimal health care. Health disparities are compounded for patients with rare diseases such as hereditary angioedema (HAE), an autosomal dominant genetic disorder characterized by recurrent, severe abdominal pain and life-threatening oropharyngeal or laryngeal swelling.
OBJECTIVE
To explore the challenges of managing patients with HAE in rural areas and suggest possible improvements for optimizing care.
DATA SOURCES
PubMed was searched for articles on patient care management, treatment challenges, rural health, and HAE.
STUDY SELECTIONS
Relevant articles were selected and reviewed.
RESULTS
Challenges in managing HAE in the rural setting were identified, including obtaining a diagnosis of HAE, easy access to a physician with expertise in HAE, continuity of care, availability of telemedicine services, access to approved HAE therapies, patient education, and economic barriers to treatment. Ways to improve HAE patient care in rural areas include health care provider recognition of the patient with undiagnosed HAE, development of individualized management plans, expansion of telemedicine, effective care at the local level, appropriate access to HAE medication, and increased awareness of patient support and advocacy groups.
CONCLUSION
For patients with HAE living in rural areas, optimal care is complicated by health disparities. Given the scarcity with which these topics have been covered in the literature to date, it is intended that this article will serve as the impetus for a range of further initiatives focused on improving access to care.

Identifiants

pubmed: 34628006
pii: S1081-1206(21)01126-1
doi: 10.1016/j.anai.2021.09.026
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

526-533

Informations de copyright

Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.

Auteurs

Marc A Riedl (MA)

Division of Rheumatology, Allergy, and Immunology, Department of Medicine, University of California San Diego, San Diego, California. Electronic address: mriedl@ucsd.edu.

Douglas T Johnston (DT)

Carolina Asthma and Allergy Center, Charlotte, North Carolina.

John Anderson (J)

Alabama Allergy and Asthma Center, Birmingham, Alabama.

J Allen Meadows (JA)

Alabama College of Osteopathic Medicine, Montgomery, Alabama.

Daniel Soteres (D)

Asthma and Allergy Associates PC, Colorado Springs, Colorado.

Stephen B LeBlanc (SB)

Division of Allergy and Immunology, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.

H James Wedner (HJ)

The Asthma and Allergy Center, Washington University School of Medicine, St Louis, Missouri.

David M Lang (DM)

Department of Allergy and Clinical Immunology, Respiratory Institute, Cleveland Clinic, Cleveland, Ohio.

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