St James’s Hospital designated as Ireland’s first centre of excellence for urticaria care
Centre of Reference and Excellence at St. James’s Hospital’s Immunology Department will improve diagnosis, treatment and care of this debilitating condition
The Immunology Department at St James’s Hospital has been designated the first UCARE Centre (Urticaria Centre of Reference and Excellence) in Ireland, following accreditation from the Global Allergy and Asthma European Network.
Chronic spontaneous urticaria refers to hives that come and go without any obvious trigger, lasting for longer than 6 weeks. It is a common condition affecting 1 in 100 people and is almost three times more common in females. While many people will experience acute urticaria at some point in their lives in the form of hives which resolve within a few days, chronic urticaria is a debilitating condition which can be challenging for clinicians to treat. In Europe, the mean time to diagnosis is 2-4 years. Patients with chronic urticaria report significantly impacted quality of life and poor sleep. Comorbid mood disorders such as anxiety and depression are common. Angioedema, a term referring to swelling of the deeper layers of the skin, is a feature in approximately half of patients.
The first line of treatment for chronic urticaria is a second generation antihistamine. Up to 40% of patients however will not respond to this treatment. A high-cost monoclonal antibody, Omalizumab, is used in patients with refractory urticaria on a case-by-case basis. Omalizumab is currently only accessible to patients who are under the care of a specialist centre, since it requires in-hospital administration and support. In St. James’s Hospital, home administration of Omalizumab is an option for suitable candidates once they are established on treatment. While home administration of omalizumab is not available at all centres, it offers the important benefit of reducing the frequency of hospital visits for these patients.
As the first and only centre of excellence for urticaria in Ireland, St James’s Hospital is working to improve the management of this condition. To become a certified UCARE centre, the Immunology Department underwent a comprehensive audit, fulfilling 32 requirements defined by the Global Allergy and Asthma European Network. The UCARE accreditation outlines a comprehensive protocol that aims to provide excellence in urticaria management, to increase the knowledge of urticaria by research and education, and to promote the awareness of urticaria by advocacy activities.
This work was led by Prof. Niall Conlon, Consultant Clinical Immunologist, Dr Cliodhna Murray, Immunology Specialist Registrar and Dr Katie Ridge, Immunology Specialist Registrar and Wellcome Health Research Board ICAT Fellow.
‘UCARE accreditation represents a significant step forward for St. James’s Hospital Immunology in our efforts to more effectively help patients with this challenging and distressing skin condition. I am very grateful for the efforts not only of our immunology doctors and nurses, but also our pharmacists and hospital management who have supported the delivery of such high standards of care for this neglected and often misunderstood patient group. We are looking forward to collaborating with the UCARE network and improving outcomes for people who suffer from urticaria, angioedema and related disorders over the coming years,’ said Prof. Niall Conlon.
St. James’s Hospital is also working with the Irish Skin Foundation to identify better ways of supporting patients who are living with urticaria in Ireland. This will involve the launch of new educational materials to improve awareness and understanding of urticaria, as well as patients having access to the ‘Ask A Nurse’ Irish Skin Foundation service, which provides free and specialist guidance on living with a chronic skin condition.
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