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Clinical Perspective: EHR and Drug Reference Data Reveals Late-Blooming Allergy Trends

by Anne Meneghetti, MD, Executive Director of Medical Information, Epocrates

It all started with a big sneeze. Anecdotal evidence of earlier and more intense allergic rhinitis led to an analysis of point-of-care data, including electronic health record (EHR) data, which shows the 2013 allergy season has yet to peak. At this time last year, the number of patients across the country seeking medical care for allergies had already begun to decline.

When the 2009 flu hit, Google showed that consumer Web searches for flu symptoms correlated with Centers for Disease Control flu stats. During that same period, Epocrates noted a correlation with clinician flu-drug lookups on our mobile drug reference app.

This year, Epocrates synthesized data from allergy-drug lookups with aggregated data on allergic rhinitis patient visits from the 40,000+ providers on athenahealth’s cloud-based services, to reveal new insights into the current allergy season. While my colleagues on athenahealth’s Analytics team will go into more detail in a forthcoming post, some highlights of our findings include:

  • The U.S. West and South were hit early, but are not in the clear – Allergic rhinitis accounted for 8% of visits in March and April, a 20% increase over 2012 for the West.
  • Midwest and Northeast are late bloomers – Lookups and visits in these regions were down 20% compared to last year, but there was a significant uptick in April, and the traditional peak had not yet occurred.
  • Nasal route tops therapeutic approaches – More than 50% of all allergic rhinitis prescriptions were for nasal sprays.

You can also see the regional breakdown of these allergy trends via the following infographic:
Infographic: Allergy Sufferers Seek Releif at Doctor's Office
(Click on graph for larger version.)

The underlying causes are likely due, in part, to climate trends. Warmer, wetter weather tends to bring an earlier, more exuberant pollen season. In recent years, warmer winters have meant that spring has come early; with that, pollen season has started earlier and extended longer in several regions of the country.

This data means that clinicians will be considering an allergic etiology for rhinitis symptoms during more months of the year, and that they can expect to see an increase in patient visits. Responding to this year’s allergic rhinitis trend, I recommend clinicians also turn to some of the resources Epocrates offers: Allergy & Hay Fever patient education items, Allergic rhinitis disease monograph with summaries of various clinical practice guidelines, and our entire Allergy/Cold/ENT drug class in the Epocrates prescription drug reference.

Integrating clinician lookup data, patient visit data, and prescription data offers a rare glimpse into disease trends. Harnessing data in this way could lead to earlier detection of disease outbreaks, and could provide an advantage to public health initiatives in the near term.

In the years ahead, imagine how exciting it would be to tap these rich data sources to reveal meaningful outcomes data on complex issues such as multi-modal cancer therapy, pre-procedural cardiac diagnostics, and sentinels for psychiatric decompensation. Discovering the diagnostic and treatment approaches that result in the best outcomes for individual patients, the optimal efficiency for practices, and the right point on the cost curve can benefit all of us in the health care ecosystem.

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