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ASCIA Progress Report - National Allergy Council (NAC) Shared Care for Allergy (SCA) Project

ASCIA’s involvement in the NAC SCA project  includes mentorship, education and training of health professionals, to improve knowledge and experience in managing allergic disease in the context of shared care. 

Shared Care Consultation Meetings

ASCIA has actively promoted the Shared Care consultation meetings to ASCIA members and other health professionals through e-newsletters, direct email and social media. This has resulted in a range of health professionals being well represented at these meetings throughout Australia. Feedback to ASCIA from meeting participants has been positive and they have welcomed the opportunity to provide input.

Gap Analysis – Anaphylaxis and Allergy Training

ASCIA is undertaking scoping work to determine the current allergy training being provided in medical and allied health professional undergraduate degrees/certificates.

ASCIA has progressed an extensive gap analysis to scope the current anaphylaxis and allergy training provided to undergraduate students for a range of  health disciplines. ASCIA will engage with relevant stakeholders to determine the benefits, enablers and barriers for incorporating anaphylaxis and allergy training into undergraduate courses.

• An initial scoping report of current providers of undergraduate healthcare degrees has been completed.
• ASCIA has developed a comprehensive list of contacts for tertiary institutions that provide degrees for medical practitictioners (including general practitioners, physicians and paediatricians), nurses, nurse practitioners, psychologists, dietitians, and paramedics.

Surveys evaluating ASCIA anaphylaxis and allergy e-training courses for health professionals have been undertaken:

• Data from voluntary post-training evaluation surveys for ASCIA anaphylaxis e-training for health professionals from December 2021 to December 2022 have been analysed and results entered into a report which is available here.
  HP Anaphylaxis Report 2022694.21 KB and also on the ASCIA website https://www.allergy.org.au/ascia-reports
• Data collected from January 2023 to July 2023 will be analysed and a report will be developed.
• Further reports will be developed from survey data collected on annual basis.

The following surveys to determine the current anaphylaxis and allergy training in undergraduate health professional degrees have been developed in Qualtrics 

• Survey 1 in July/August 2023 for health professional graduates to understand their undergraduate experience of anaphylaxis and allergy training. This survey will be implemented by promotion through health professional organisations, e-newsletters, direct email and social media. This survey is available at https://www.allergy.org.au/hp
• Survey 2 in September/October 2023 for representatives from institutions. It is our intention to implement the survey by contacting relevant stakeholders. ASCIA has developed a comprehensive list of contacts for tertiary institutions that provide degrees for health disciplines which are approved by the Australian Health Practitioner Regulation Agency (AHPRA). 

The results of all of the surveys listed above will be summarised in reports to:

• Highlight factors influencing the decision to incorporate anaphylaxis and allergy training in undergraduate degrees.
• Provide insights into the benefits of including anaphylaxis and allergy training for future health professionals.
• Outline potential improvements in ASCIA e-training courses based on feedback in the reports on ASCIA anaphylaxis and allergy e-training courses for health professionals.
• Provide feedback to assist in developing consistent minimum standards/competencies for anaphylaxis and allergy training across institutions.

Gap Analysis – Resource Management

A comprehensive review of ASCIA website resources accessible to patients, carers and health professionals has been completed on 31 May 2023. Each individual resource has been catalogued in a spreadsheet that now forms an integral part of the collaborative gap analysis. This spreadsheet will be maintained and updated on a continual basis as new and revised resources become available.  The intention is to have this available open access on the ASCIA website www.allergy.org.au/about-ascia/website-information#s1

Promotion of Patient/Carer Support Organisations 

• ASCIA Fast Facts have provided concise, reliable and easy to read information about allergies and other immune system disorders since they were first developed in 2019. ASCIA Fast Facts are the first online resources for patients and carers that have been reviewed and updated in 2023 to ensure that plain language is used where possible, and links to patient and carer support organisations are included at the top of each document. These updates have been made by ASCIA as part of the National Allergy Council Shared Care for Allergy project. The updated ASCIA Fast Facts are available at www.allergy.org.au/patients/fast-facts on 20 topics.
• ASCIA Dietary Guides for Food Allergy have been updated with links to patient and carer support organisations included at the top of each document. The previous versions had blue “Dietary Guide” headers which are no longer used, as it is important to make it clear that these resources are for patients and carers and “Dietary Guide” is now stated in the title of each document. In October 2022 each of the 11 Dietary Guide webpages were updated to include ReadSpeaker, to improve accessibility. The updated ASCIA Dietary Guides for Food Allergy are available at www.allergy.org.au/patients/food-allergy/ascia-dietary-avoidance-for-food-allergy for 10 allergen groups, as well as general information in a Frequently Asked Questions (FAQ) for patients and carers.
• ASCIA Dietary Guides for the Four Food Elimination Diet (4FED) and Two Food Elimination Diet (2FED) for Eosinophilic Oesophagitis (EoE) have been updated with links to patient and carer support organisations included at the top of each document. The previous versions had blue “Dietary Guide” headers which are no longer used, as it is important to make it clear that these resources are for patients and carers and “Dietary Guide” is now stated in the title of each document. ReadSpeaker is available on the Dietary Guide webpages to improve accessibility. The updated ASCIA Dietary Guides for EoE are available at 
  www.allergy.org.au/patients/food-other-adverse-reactions/eoe-2fed
  www.allergy.org.au/patients/food-other-adverse-reactions/eoe-4fed

ASCIA Progress Report - National Allergy Council (NAC) Schools and Children’s Education/Care (CEC) Project

ASCIA’s involvement in the NAC Schools and CEC project includes education and training of staff in schools and CEC services, to improve knowledge about management of allergies and anaphylaxis. 

Gap analysis to determine current allergy education being provided

• Initial scoping research detailing the progress of the gap analysis has been completed.
• The full gap analysis is expected to be completed by 31 December 2023.

Surveys

• A survey for people studying and/or working within the education industry (schools and children’s education/care services) to determine how anaphylaxis training is being provided in undergraduate courses was completed during June 2023 and was available at www.allergy.org.au/schools-childcare which was promoted via newsletters, direct email and social media. Analysis of the survey data is expected to be completed by 31 December 2023. 
• Mandatory evaluation surveys were added to these courses in January 2023 and survey data from January to July 2023 will be analysed. Based on this data, ASCIA will develop a plan by November 2023 to consult with users, which is likely to include conducting focus groups. 
• Data from voluntary post-training evaluation surveys for ASCIA anaphylaxis e-training for Schools and Children's Education/Care (CEC) from December 2021 to December 2022 has been evaluated and results will inform course reviews and updates. Reports are available here: 
  
  Schools 2022 Report629.44 KB   
  
  CEC 2022 Report583.28 KB
  

The results of these surveys will be summarised in reports to:

• Highlight factors influencing the decision to incorporate anaphylaxis training in undergraduate degrees.
• Provide insights into the benefits of including anaphylaxis training for future educators.
• Outline potential improvements in ASCIA e-training courses based on feedback.
• Provide feedback to assist in developing consistent minimum standards/competencies for anaphylaxis training across institutions.

Updating ASCIA anaphylaxis e-training for schools and CEC

Major updates have been made to these courses in June and July 2023 to include the 2023 versions of ASCIA Action Plan for Anaphylaxis (red), ASCIA Action Plan for Allergic Reactions (green), ASCIA Action Plan for Drug (Medication) Allergy (dark green) and ASCIA First Aid Plan for Anaphylaxis (orange). Details of the updates are on the ASCIA website: https://www.allergy.org.au/about-ascia/info-updates/new-2023-versions-of-ascia-action-plans-for-anaphylaxis

ASCIA has developed new 2023 versions of ASCIA Action Plans for Anaphylaxis and ASCIA First Aid Plans for Anaphylaxis, to improve ease of use, which are available from June 2023 onwards. This is the first major formatting change in 20 years, since ASCIA Action Plans for Anaphylaxis were first introduced in 2003. The plans can be accessed on the ASCIA website:

• www.allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis
• www.allergy.org.au/hp/ascia-plans-action-and-treatment

Increase the uptake of ASCIA anaphylaxis refresher training by schools and CEC 

• ASCIA anaphylaxis refresher e-training courses for schools, CEC and community have been promoted in monthly ASCIA Community newsletters from July 2022 to June 2023. These newsletters are sent to more than 5,000 recipients each month.
• A promotion plan for ASCIA social media has been developed, to be implemented from July 2023 onwards 
• From 1 July 2021 to 30 June 2022 there were 6,028 enrolments for ASCIA Anaphylaxis Refresher e-training of which 681 had not yet completed the course.
• From 1 July 2022 to 30 June 2023 there were 5,277 enrolments for ASCIA Anaphylaxis Refresher e-training of which 653 had not yet completed the course.

Maintain ASCIA anaphylaxis e-training for schools and CEC services

• In addition to the June/July updates, courses have been updated in January 2023 and September 2022 to include addition of mandatory evaluation surveys and product changes (Anapen and EpiPen).
• Once evaluation reports are completed further course improvements will be made.

Provide support for users of the ASCIA anaphylaxis e-training for schools and CEC

• ASCIA provides ongoing email and online support for ASCIA anaphylaxis e-training for schools and CEC services.
• ASCIA responds to approximately 300 inquiries regarding the courses per month.

Nestlé Health Science has advised that they will be out of stock of the current recipe of Alfamino® 400g specialised formula for infants with cow's milk allergy  from around mid-July until the end of August 2023. They expect that it will be available again in pharmacies around early September.

Alfamino stock notification for parents and carers114.08 KB

Nestlé Health Science is aware of the difficulties this will pose for some parents and caregivers, and apologise for this situation.  

Alfamino® infant formula has a new recipe. Nestlé Health Science awaits PBS listing confirmation for this product to be able to supply it through pharmacies at the PBS subsidised price. In the interim period, the new recipe Alfamino® will be available to parents and caregivers through the online Nestlé Baby Store Products – Nestlé Baby Store (nestlebaby.com.au). The new recipe Alfamino® continues to be an amino acid based infant formula for infants (0-12 months) with severe cow’s milk protein allergy, eosinophilic oesophagitis, intestinal malabsorption and/or multiple food intolerances. Parents and carers should speak to their healthcare professional for advice. For more information, contact Nestlé Health Science Consumer Services on 1800 671 628.  

ALFAMINO® is an infant formula product for special dietary use and must be used under medical supervision. It is not suitable for general use.

The ASCIA Guide for Milk Substitutes in Cow’s Milk Allergy provides information about safe, nutritionally equivalent alternatives for infants with cow’s milk allergy, if a particular specialised formula is not available due to supply issues.. The ASCIA Guide is available at https://www.allergy.org.au/hp/papers/guide-for-milk-substitutes-cows-milk-allergy 

IMPORTANT NOTICE: Breast milk is best for babies and provides ideal nutrition.  Good maternal nutrition is important for the preparation and maintenance of breastfeeding.  Introducing partial bottle feeding could negatively affect breastfeeding and reversing a decision not to breastfeed is difficult.  Professional advice should be followed on infant feeding.  Infant formula should be prepared and used exactly as directed or it could pose a health hazard.  The preparation requirements and weekly cost of providing infant formula until 12 months of age should be considered before making a decision to formula feed. Mothers should be encouraged to continue breastfeeding even when their infants have cow’s milk protein allergy. If a decision to use an infant formula for special dietary use is taken, it must be used under medical supervision.

ASCIA Fast Facts have provided concise, reliable and easy to read information about allergies and other immune system disorders since they were first developed in 2019. ASCIA Fast Facts are the first online resources for patients and carers that have been reviewed and updated in 2023 to ensure that plain language is used where possible, and links to patient and carer support organisations are included at the top of each document. These updates have been made by ASCIA as part of the National Allergy Council Shared Care for Allergy project. 

The updated ASCIA Fast Facts are available online at www.allergy.org.au/patients/fast-facts on the following on 20 topics.

•   Adrenaline (Epinephrine) Injectors
•   Allergic Rhinitis (Hay Fever)
•   Allergy Testing
•   Allergy Treatments
•   Anaphylaxis
•   Asthma and Allergy
•   Autoimmune Disease
•   Cow’s Milk (Dairy) Allergy
•   Drug (Medication) Allergy
•   Eczema (Atopic Dermatitis) 
•   Eczema and Food Allergy
•   Evidence-based Allergy Tests and Treatments
•   Food Allergy
•   Immune System
•   Immunodeficiencies
•   Infant Feeding and Allergy Prevention
  
•   Insect and Tick Allergy
  
•   Peanut Allergy
•   Seed Allergy
•   Tree Nut Allergy

ASCIA has developed new 2023 versions of ASCIA Action Plans for Anaphylaxis, to improve ease of use, which are now available. This is the first major formatting change in 20 years, since ASCIA Action Plans for Anaphylaxis were first introduced in 2003. The plans can be accessed on the ASCIA website:

• www.allergy.org.au/hp/anaphylaxis/ascia-action-plan-for-anaphylaxis
• www.allergy.org.au/hp/ascia-plans-action-and-treatment

Whilst the signs of, and actions for anaphylaxis are unchanged, other updates have been made to improve ease of use:

1. Patient specific details are all completed in the top section.* 
2. Signs of, and actions for mild to moderate allergic reactions are in two easy to follow lists. 
3. Wording about allergen exposure is included in the asthma section at the end of the plan.
4. Instructions for adrenaline injectors are colour coded.
5. Instructions for both adrenaline injectors are included in the General version of the plan.
6. Device specific versions of the plan for Anapen^® and EpiPen^® include changes 1-4 listed above and a QR code which links to short animated videos with adrenaline injector instructions.

* This formatting may also facilitate use with some EMR systems, subject to approval by ASCIA.  

The format of the following plans have also been updated to be consistent with the 2023 versions of the red ASCIA Action Plan for Anaphylaxis:

• ASCIA Action Plan for Allergic Reactions (green)
• ASCIA Action Plan for Drug (Medication) Allergy (dark green)
• ASCIA First Aid Plan for Anaphylaxis (orange)
• ASCIA Travel Plan for People at Risk of Anaphylaxis (red) for use with the red ASCIA Action Plan for Anaphylaxis

 A summary of updates is available here.

ASCIA Action Plan for Anaphylaxis 2023 - What's New431.38 KB

ASCIA Action Plan Allergic Reactions 2023 - What's New321.66 KB

ASCIA Action Plan Drug Allergy 2023 - What's New338.87 KB

ASCIA First Aid Plan Anaphylaxis 2023 - What's New415.79 KB 

ASCIA Travel Plan Anaphylaxis 2023 - What's New398.97 KB

ASCIA anaphylaxis e-training courses are being updated to include the 2023 versions of the plans, and the courses are expected to be ready in July 2023.

Previous versions of ASCIA Action Plans (2021 and 2022 versions) can still be used in 2023, as we expect that it will take around six  months to phase in the use of the new 2023 plans.

Suppliers of Anapen and EpiPen are printing the new plans, for prescribers who prefer to complete a printed version.

ASCIA has been progressing work on the following National Allergy Council projects since July 2022:

• Shared Care for Allergy project - The aim of this project is to improve access to quality healthcare for people with allergies, particularly in regional, rural and remote areas. The latest updates are available at https://www.allergy.org.au/about-ascia/info-updates/ascia-progress-report-nac-shared-care-for-allergy-project

• Schools and Children’s Education/Care (CEC) Services project - The aim of this project is to provide consistent guidelines and improve knowledge about management of allergies and anaphylaxis in schools and CEC services. The latest updates are available at https://www.allergy.org.au/about-ascia/info-updates/ascia-progress-report-nac-schools-and-cec-project

Increased Staff Capacity

• ASCIA employed two project officers to work on the National Allergy Council projects who commenced work on 1^st March 2023, as listed on the ASCIA website  www.allergy.org.au/members/committees#d
• In addition, existing ASCIA staff and contractors are working to progress work on the National Allergy Council projects.