D2.48 - Evolving Trends in Pediatric Allergy Referrals Over the Past Decade

The prevalence of allergic diseases among children has risen significantly in recent decades. It is crucial to analyze referral trends within this population and monitor pattern shifts to enhance diagnosis and management, as well as to allocate resources efficiently.

We retrospectively analyzed referrals to the pediatric allergy outpatient clinic in January-February of 2014 and 2024. Collected data included patient demographics, reasons for referral, and the source of referral. Chi-Square test was used to assess the statistical significance of observed frequency shifts, and the Mann-Whitney U test was applied to evaluate differences in patient age. Significance level was set at p<0.05.

In 2014, 113 patients were referred: 49 females (43.4%), median age of 11 years [4 months-18 years]. Most referrals originated from other hospital departments (53.1%), particularly pediatrics (43.3%) and otorhinolaryngology (ENT) (23.3%), with lesser contributions from primary care (26.5%), other hospitals or the private sector (15%), emergency departments (ED) (3.5%), and inpatient settings (1.8%). Reasons for referral were as follows: respiratory allergy (RA) 46.9%, food allergy (FA) 10.6%, cutaneous allergy (CA) 10.6%, and drug allergy (DA) 9.7%. Insect venom allergy was noted in 1.8%, while 20.4% of patients presented with multiple complaints (mostly RA + CA).

In 2024, 194 patients were referred: 93 females (47.9%), median age of 8 years [3 months-18 years]. Primary sources of referral shifted, with a greater proportion coming from primary care (57.2%) compared to other hospital departments (30.4%) - ENT (49.2%) and pediatrics (42.4%). Smaller contributions were noted from ED (7.2%), other hospitals or the private sector (3.6%), inpatient settings (1.0%), and day hospitals (0.5%). Changes in referral motives were also observed: RA remained the leading reason at 47.9%, followed by DA at 24.2%, CA at 11.9%, FA at 9.8%, and multiple complaints at 6.2% (mostly RA + CA).

Over the past decade, we observed an increase in referrals, a decrease in the average age of referred patients and a rise in primary care referrals, suggesting increased awareness and screening of allergy-related conditions. Referrals from the private sector have declined, likely due to the sector's expansion with increased offer of specific appointments. Also, referrals from the ED doubled, enabling early access to appointments at the allergy clinic without the need for intermediate consultations with other specialties. Referrals for DA more than doubled, with no significant changes for other referral motives. These trends highlight the importance for allergists to enhance collaboration with primary care providers, stay updated on DA diagnostics, and allocate resources to this area.