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Alvarez AA, Palka JM, Khan DA. Severe Multiple Drug Intolerance Syndrome in Fibromyalgia and Irritable Bowel Syndrome. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2024; 12:1192-1201. [PMID: 38278325 DOI: 10.1016/j.jaip.2024.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/05/2024] [Accepted: 01/13/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Multiple drug intolerance syndrome (MDIS) describes patients with multiple nonimmunologically mediated adverse reactions to medications. Patients with more than 10 medication intolerance labels are considered to have severe MDIS. There is overlap in the characteristics of patients with MDIS and fibromyalgia and irritable bowel syndrome (IBS). Severe MDIS can limit treatment options in this already complex patient group. OBJECTIVE This study assessed the prevalence of severe MDIS in patients with fibromyalgia and IBS and its associated risk factors. METHODS A retrospective chart review identified patients diagnosed with fibromyalgia or IBS who had been seen at a large academic center from August 2019 to July 2020. Exact birthdate- and sex-matched controls who had been seen within the same time frame were selected at random. Listed drug intolerance data and patient characteristics were then analyzed with logistic regression and χ2 testing. RESULTS Patients with fibromyalgia and IBS were 12 and 3 times more likely to have severe MDIS compared with controls, respectively. Severe MDIS was associated with polypharmacy in both groups. Opiates were the most frequently reported drug intolerance across all participants. Although patients with IBS more often reported gastrointestinal symptoms as adverse reactions, individuals with fibromyalgia did not more frequently report pain or behavioral changes as adverse reactions. CONCLUSIONS There was an increased rate of severe MDIS in patients diagnosed with fibromyalgia and IBS. Additional studies are needed to better understand the morbidity of MDIS and how it can best be managed in patients with fibromyalgia and IBS.
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Affiliation(s)
- Alicia A Alvarez
- First Physicians Group, Sarasota Memorial Hospital, Sarasota, Fla.
| | - Jayme M Palka
- Department of Internal Psychiatry, University of Texas Southwestern Medical Center, Dallas, Texas
| | - David A Khan
- Department of Internal Medicine, Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
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van den Berk-Clark C, Grant A, Ferber M. Internalizing disorders as a mediator of the association between adverse childhood experiences and perceived medication intolerance or poly-allergy. Int J Psychiatry Med 2023; 58:591-604. [PMID: 37168017 DOI: 10.1177/00912174231175742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVES There is a well-established link between adverse childhood events, mental health, and physical health conditions. There is also a large literature showing the relationship between medication intolerance or allergies, and poor health outcomes. However, less is understood about the role of medication intolerance and adverse childhood events. Thus, the present study examines the relationship between adverse childhood events, internalizing disorders (depression, anxiety) and medication intolerance. METHOD Three hundred forty-nine participants were recruited from 11 primary care practices and health networks located in a large, Midwestern metropolitan area. Unrelated linear and Poisson regression was used to determine whether internalizing disorders, such as depression and anxiety, mediated the relationship between adverse childhood experiences (ACEs) and allergies to medications, accounting for error terms in regression equations that were correlated. RESULTS Results indicated an association between ACEs and number of allergies to medication, whereby ACEs was associated with depression, anxiety and number of allergies. Sensitivity analysis confirmed these findings. There was a small but significant indirect effect of anxiety on allergies to medication after bootstrapping. CONCLUSION This study found that inflammatory responses occurring because of trauma and depression may be increasing medication allergies. However, given the size of the sample, more research is needed to confirm these results. Implications for healthcare providers are discussed.
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Affiliation(s)
| | - Abigail Grant
- Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA
| | - Megan Ferber
- Department of Family and Community Medicine, Saint Louis University, St. Louis, MO, USA
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Martini M, Di Taranto M, Höfer V, Worm M, Bilò MB. Health-Related Quality of Life and Mental Health in Drug Hypersensitivity Reactions and Drug-Induced Anaphylaxis: A Systematic Review and Meta-Analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:1876-1890. [PMID: 36958518 DOI: 10.1016/j.jaip.2023.03.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 02/20/2023] [Accepted: 03/06/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Drug hypersensitivity reactions (DHRs) are adverse drug reactions (ADRs) that are particularly impactful on health-related quality of life (HRQoL) and mental health. Although the role of HRQoL as an important patient-reported outcome has been recognized in past years, HRQoL and mental health in patients with ADRs are still poorly investigated. OBJECTIVE To evaluate the prevalence, severity, and risk factors of HRQoL and mental health in DHRs, with a particular focus on drug-induced anaphylaxis. METHODS We searched the MEDLINE, Scopus, and American Psychological Association PsycArticles databases to identify all studies up to December 31, 2022 that included subjects with at least one episode of DHR and assessments of mental health and/or quality of life. Results were reported as qualitative and quantitative analyses, with meta-analyses after assessment for risk of bias and heterogeneity. RESULTS A total of 45 observational studies were included. Overall, a high prevalence of depression (up to 51.4%; odd ratio = 2.94; 95% CI, 1.42-6.10) and anxiety (up to 48%; odd ratio = 3.92; 95% CI, 1.91-8.05) were reported compared with healthy subjects. The HRQoL was significantly affected, especially in the case of drug-induced anaphylaxis (mean score, +5.88; 95% CI, 0.77-10.98). CONCLUSIONS Despite the scarce and heterogeneous studies on this topic, the review shows that HRQoL and mental health are markedly affected after ADRs. A better assessment of HRQoL and characterization of patients' mental status may improve the efficacy of therapeutic strategies, which should include psychological support.
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Affiliation(s)
- Matteo Martini
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; Allergy Unit, Ospedali Riuniti Marche Nord, Fano, Italy.
| | - Mariateresa Di Taranto
- Istituto di Ricerca di Psicoanalisi Applicata Postgraduate School of Psychoanalysis, Ancona, Italy
| | - Veronika Höfer
- Division of Allergy and Immunology, Department of Dermatology, Venerology, and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Margitta Worm
- Division of Allergy and Immunology, Department of Dermatology, Venerology, and Allergology, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Maria Beatrice Bilò
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy; Allergy Unit, Department of Internal Medicine, University Hospital Ospedali Riuniti di Ancona, Italy.
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Jagpal PK, Alshareef S, Marriott JF, Krishna MT. Characterization, epidemiology and risk factors of multiple drug allergy syndrome and multiple drug intolerance syndrome: A systematic review. Clin Transl Allergy 2022; 12:e12190. [PMID: 36017174 PMCID: PMC9395947 DOI: 10.1002/clt2.12190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 08/04/2022] [Accepted: 08/11/2022] [Indexed: 11/18/2022] Open
Abstract
Background Multiple drug allergy and multiple drug intolerance syndrome (MDAS/MDIS) labels are an impediment to clinical care and knowledge regarding these conditions is limited. This systematic review investigated the characterization, epidemiology, risk factors, clinical impact and pharmaco-economics of MDAS and MDIS. Methods Systematic literature search across 11 databases (01 January 2000-06 November 2020) for MDIS, MDAS and related terminology. Studies were reviewed for quality of evidence and risk of bias by employing Critical Appraisal Skills Programme cohort study checklist. A narrative synthesis approach facilitated by systematic textual descriptions, tabulation and thematic analysis was adopted. Results There was heterogeneity in terminology and methodology. Few studies applied standard drug allergy diagnostic methods. There is some evidence to suggest that multiple drug hypersensitivity syndrome (MDHS; i.e., confirmed allergies in MDAS) is a distinct clinical entity. Prevalence of MDIS and MDAS labels in unselected & selected populations varied between 2.1%-6.4% & 4.9%-90% and 1.2% & 0%-36% respectively. Reported risk factors included female gender, increasing age, body mass index, anxiety, depression, co-morbidities, concurrent allergies and increased healthcare utilization. Drugs commonly implicated were antibiotics and non-steroidal anti-inflammatory drugs. No studies relating to clinical impact and pharmaco-economics were found. Conclusion There is considerable burden of MDAS and MDIS labels. Data needs cautious interpretation as majority of studies described involved unverified labels. Despite this limitation and heterogeneity of studies, there is some evidence to suggest that MDHS is a distinct clinical entity. Well-designed multi-centre studies applying standardized terminology and diagnostic methodology are needed to gain further insight into these conditions.
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Affiliation(s)
- Parbir K Jagpal
- Institute of Clinical Sciences University of Birmingham Birmingham UK
| | - Saad Alshareef
- University Hospitals Birmingham NHS Foundation Trust Birmingham UK
| | - John F Marriott
- Institute of Clinical Sciences University of Birmingham Birmingham UK
| | - Mamidipudi Thirumala Krishna
- University Hospitals Birmingham NHS Foundation Trust Birmingham UK
- Institute of Immunology and Immunotherapy University of Birmingham Birmingham UK
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Bassir F, Varghese S, Wang L, Chin YP, Zhou L. The Use of Electronic Health Records to Study Drug-Induced Hypersensitivity Reactions from 2000 to 2021: A Systematic Review. Immunol Allergy Clin North Am 2022; 42:453-497. [PMID: 35469629 PMCID: PMC9267416 DOI: 10.1016/j.iac.2022.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Electronic health records (EHRs) have revolutionized the field of drug hypersensitivity reaction (DHR) research. In this systematic review, we assessed 140 articles from 2000-2021, classifying them under six themes: observational studies (n=61), clinical documentation (n=27), case management (n=22), clinical decision support (CDS) (n=18), case identification (n=9), and genetic studies (n=3). EHRs provide convenient access to millions of medical records, facilitating epidemiological studies of DHRs. Though the goal of CDS is to promote safe drug prescribing, allergy alerts must be designed and used in a way that supports this effort. Ultimately, accurate allergy documentation is essential for DHR prevention.
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Affiliation(s)
- Fatima Bassir
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA; Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA.
| | - Sheril Varghese
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA
| | - Liqin Wang
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA
| | - Yen Po Chin
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA
| | - Li Zhou
- Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 399 Revolution Drive, Suite 1315, Somerville, MA 02145, USA
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Patient-reported drug and latex allergies negatively affect outcomes after total and reverse shoulder arthroplasty. J Shoulder Elbow Surg 2021; 30:2753-2761. [PMID: 34087274 DOI: 10.1016/j.jse.2021.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 02/01/2023]
Abstract
BACKGROUND Patient-reported allergies (PRAs) have been identified as a risk factor for worse outcomes and less satisfaction in patients undergoing knee and hip arthroplasty. Similar associations have not been elucidated in shoulder arthroplasty patients; however, previous research is sparse. The purpose of this study was to assess the outcomes following shoulder arthroplasty surgery with respect to patient-reported drug allergies. It was hypothesized that a higher number of allergies would be associated with worse patient-reported outcomes (PROs) following shoulder arthroplasty surgery. METHODS Consecutive patients aged 18-89 years at the time of surgery who underwent primary shoulder arthroplasty between October 2005 and March 2018 performed by a single surgeon and had a minimum follow-up period of 1 year were reviewed. PRO scores, including the American Shoulder and Elbow Surgeons score, Single Assessment Numerical Evaluation score, QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score, and 12-Item Short Form Health Survey Physical Component Summary and Mental Component Summary scores, as well as patient satisfaction, were collected preoperatively and postoperatively. Early clinical failures were reported. Subjects were categorized into a 3-level factor based on the number of PRAs (0, 1, or ≥2), and bivariate comparisons of mean postoperative PRO scores were performed using Kruskal-Wallis analyses. Additionally, multivariate regression was performed to assess the effect of PRAs on PROs while controlling for age, sex, arthroplasty type, baseline PRO scores, and Charlson Comorbidity Index. RESULTS Overall, 411 shoulders were included in the final study population (367 patients, 44 of whom were treated bilaterally). The population was predominately male patients (n = 265, 64.5%), and the median age at the time of surgery was 66.5 years (first quartile-third quartile, 61.3-71.4 years). Of the patients, 253 (61.6%) underwent total shoulder arthroplasty (TSA) whereas 158 (38.4%) underwent reverse TSA. Five patients (2 TSA and 3 reverse TSA patients) experienced early clinical failure and required revision surgery. Minimum 1-year PROs were obtained for 345 of 406 patients (85.0%) with a mean follow-up period of 1.9 ± 1.2 years. Nearly all postoperative PROs reflected a trend of worse outcomes with more preoperative PRAs; however, the QuickDASH score was the only score showing a significant difference between allergy groups (P = .004). Pair-wise comparison using Nemenyi post hoc testing showed that the QuickDASH score was significantly higher (worse outcomes) for the group with ≥2 allergies compared with the group with 0 allergies. PRA was found to be a statistically significant predictor of higher postoperative QuickDASH scores (P = .043) and was more influential than the Charlson Comorbidity Index and sex. Additionally, PRA was the only statistically significant predictor of patient satisfaction (P = .016). CONCLUSION An increasing number of preoperative PRAs is associated with worse PROs and patient satisfaction following shoulder arthroplasty. The number of PRAs was the most influential predictor of patient satisfaction.
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Blumenthal KG, Harkness T, Phillips EJ, Ramsey A, Banerji A, Samarakoon U, Stone C, Fu X, Khan DA, Otani I, Camargo CA, Zhang Y, Donelan K, Blumenthal KG, Banerji A, Harkness T, Mancini CM, Samarakoon U, Ahola CM, Judd AD, Arman W, Phillips E, Stone C, Williams K, Osea RE, Ramsey A, Mustafa SS, Blue H, Otani I, Guyer A, Khan D. Patient Characteristics and Concerns about Drug Allergy: A Report from the United States Drug Allergy Registry. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2958-2967. [DOI: 10.1016/j.jaip.2020.08.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 07/29/2020] [Accepted: 08/19/2020] [Indexed: 12/11/2022]
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Del Casale A, Ferracuti S, Mosca A, Pomes LM, Fiaschè F, Bonanni L, Borro M, Gentile G, Martelletti P, Simmaco M. Multiple Chemical Sensitivity Syndrome: A Principal Component Analysis of Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186551. [PMID: 32916833 PMCID: PMC7558401 DOI: 10.3390/ijerph17186551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 09/03/2020] [Accepted: 09/07/2020] [Indexed: 12/12/2022]
Abstract
Multiple Chemical Sensitivity (MCS) is a chronic and/or recurrent condition with somatic, cognitive, and affective symptoms following a contact with chemical agents whose concentrations do not correlate with toxicity in the general population. Its prevalence is not well defined; it mainly affects women between 40 and 50 years, without variations in ethnicity, education and economic status. We aimed to assess the core symptoms of this illness in a sample of Italian patients. Two physicians investigated different symptoms with a checklist compilation in 129 patients with MCS (117 women). We conducted a categorical Principal Component Analysis (CATPCA) with Varimax rotation on the checklist dataset. A typical triad was documented: hyperosmia, asthenia, and dyspnoea were the most common symptoms. Patients also frequently showed cough and headache. The CATPCA showed seven main factors: 1, neurocognitive symptoms; 2, physical (objective) symptoms; 3, gastrointestinal symptoms; 4, dermatological symptoms; 5, anxiety-depressive symptoms; 6, respiratory symptoms; 7, hyperosmia and asthenia. Patients showed higher mean prevalence of factors 7 (89.9%), 6 (71.7%), and 1 (62.13%). In conclusion, MCS patients frequently manifest hyperosmia, asthenia, and dyspnoea, which are often concomitant with other respiratory and neurocognitive symptoms. Considering the clinical association that is often made with anxiety, more studies are necessary on the psychosomatic aspects of this syndrome. Further analytical epidemiological studies are needed to support the formulation of aetiological hypotheses of MCS.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy
- Unit of Psychiatry, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
- Correspondence:
| | - Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, 00185 Rome, Italy;
- Unit of Risk Management, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Alessio Mosca
- Department of Neuroscience, Imaging and Clinical Sciences, “G. d’Annunzio” University, 66100 Chieti, Italy;
| | - Leda Marina Pomes
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Federica Fiaschè
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Luca Bonanni
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
| | - Marina Borro
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Giovanna Gentile
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Paolo Martelletti
- Department of Medical and Molecular Sciences, Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy;
- Headache Centre Unit, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
| | - Maurizio Simmaco
- Department of Neuroscience, Mental Health, and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, 00185 Rome, Italy; (L.M.P.); (F.F.); (L.B.); (M.B.); (G.G.); (M.S.)
- Unit of Laboratory and Advanced Molecular Diagnostics, ‘Sant’Andrea’ University Hospital, 00189 Rome, Italy
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Briones-Vozmediano E, Espinar-Ruiz E. How do women suffering from multiple chemical sensitivity experience the medical encounter? a qualitative study in Spain. Disabil Rehabil 2019; 43:1110-1120. [PMID: 31407924 DOI: 10.1080/09638288.2019.1650297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
PURPOSE Multiple Chemical Sensitivity is a condition principally suffered by women. As with fibromyalgia and chronic fatigue syndrome, Multiple Chemical Sensitivity is usually included among the so called "contested illnesses", defined as illnesses whose cause, diagnosis, prevalence and even existence are subject to controversy. This article seeks to explore how women with Multiple Chemical Sensitivity experience this contested illness, through their own descriptions of diagnostic processes, search for treatment and encounters with different health professionals. We aim to observe these experiences in detail and to identify aspects that could improve care for Multiple Chemical Sensitivity sufferers. METHOD Qualitative design. We performed personal in-depth interviews, which were recorded and transcribed to conduct a qualitative content analysis supported by Atlas.ti-7. SUBJECTS/PATIENTS 22 women diagnosed with Multiple Chemical Sensitivity in Spain. RESULTS Two main categories were identified in the interviews: (1) unavoidable barriers: patients' exposure to chemicals and the absence of treatment, and (2) Skepticism on the part of care providers and lack of recognition in the process of diagnosis. CONCLUSION Training and above all awareness raising strategies are needed to address health professionals' prejudices regarding the existence of contested illnesses such as Multiple Chemical Sensitivity. These prejudices hinder diagnosis and medical follow-up, and add negative emotions to the physical limitations already suffered by patients.IMPLICATIONS FOR REHABILITATION Multiple Chemical SensitivityIt is important to promote a compassionate and empathetic attitude among health providers, in order to avoid rejection and delegitimization of the experiences of women with Multiple Chemical Sensitivity.Multiple Chemical Sensitivity protocols should be developed and implemented to give skills to health professionals to assist patients with Multiple Chemical Sensitivity.These protocols should include avoidance of exposure to chemicals present in healthcare facilities.Training programs for health providers should include not only knowledge, but awareness raising about the characteristics and severity of contested illnesses such as Multiple Chemical Sensitivity.Health providers should avoid stigmatizing patients by psychologizing their symptoms and be aware of the existence of stereotypes regarding women suffering from Multiple Chemical Sensitivity.
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Affiliation(s)
| | - Eva Espinar-Ruiz
- Department of Sociology II, University of Alicante, Alicante, Spain
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