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Chemical/med intolerance affects 1 in 5 primary care patients; rarely diagnosed

  [ 22 votes ]   [ 3 Comments ]
www.ProHealth.com • July 23, 2012

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Article:
Chemical Intolerance in Primary Care Settings: Prevalence, Comorbidity, and Outcomes
- Source: Annals of Family Medicine, Jul-Aug 2012

By David A Katerndahl, MD, MA, et al.

[Note: read the full text of this article free at http://annfammed.org/content/10/4/357.full. Importantly, when these PC physicians at U Texas Health Science Center sought information on patients' chemical sensitivities, often these involved adverse reactions to medications, medical procedures, and medical materials that if informed the healthcare provider might avoid. The researchers add, “Perhaps most troubling is the impact that chemical intolerance has on social functioning and relationships. In the present data, impairment in daily and social activities was independent of any associated mental disorders.”]

Abstract:
Purpose: This study extends previous community-based studies on the prevalence and clinical characteristics of chemical intolerance in a sample of primary care clinic patients. We evaluated comorbid medical and psychiatric disorders, functional status, and rates of health care use.

Methods: A total of 400 patients were recruited from 2 family medicine clinic waiting rooms in San Antonio, Texas.

Patients completed the validated Quick Environmental Exposure and Sensitivity Inventory (QEESI) to assess chemical intolerance; the Primary Care Evaluation of Mental Disorders (PRIME-MD) screen for possible psychiatric disorders; the Dartmouth-Northern New England Primary Care Cooperative Information Project (Dartmouth COOP) charts for functional status; and the Healthcare Utilization Questionnaire.

Results:

• Overall, 20.3% of the sample met criteria for chemical intolerance.

• The chemically intolerant group reported significantly higher rates of comorbid allergies and more often met screening criteria for possible major depressive disorder, panic disorder, generalized anxiety disorder, and alcohol abuse disorder, as well as somatization disorder.

• The total number of possible mental disorders was correlated with chemical intolerance scores (P <.001).

• Controlling for demographics, patients with chemical intolerance were significantly more likely to have poorer functional status, with trends toward increased medical service use when compared with non-chemically intolerant patients.

• After controlling for comorbid psychiatric conditions, the groups differed significantly only regarding limitations of social activities.

Conclusions:

• Chemical intolerance occurs in 1 of 5 primary care patients yet is rarely diagnosed by busy practitioners.

• Psychiatric comorbidities contribute to functional limitations and increased health care use. Chemical intolerance offers an etiologic explanation.

• Symptoms may resolve or improve with the avoidance of salient chemical, dietary (including caffeine and alcohol), and [prescription] drug triggers.

Given greater medication intolerances in chemical intolerance, primary care clinicians could use the QEESI to identify patients for appropriate triage to comprehensive nonpharmacologic care.

Source: Annals of Family Medicine, Jul-Aug 2012; vol 10, #4, 357-365. DOI: 10.1370/afm.1346, by katerndahl, DA, Bell IR, Palmer RF, Miller, CS. Family & Community Medicine, University of Texas Health Science Center at San Antonio, Texas, USA. [Email: katerndahl@uthscsa.edu]


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DISCUSS THIS ARTICLE   (3 existing comments) Post a Comment 


Interesting
Posted by: IanH
Jul 24, 2012
This "making an average of 23.3 visits to a medical professional per year" is unbelievable. The average is around 12.5 visits per year. All the people with MCS I know avoid medical practitioners completely, knowing that they will get little or no help or get a condescending disbelief.
Reply Reply

 
I agree, but...
Posted by: jenunsa
Jul 26, 2012
I agree that people (like myself) with MCS end up avoiding doctors because we get treated like we're crazy...but I think the article surveyed people who didn't know about MCS at all. The 20% that met the criteria for being chemically sensitive were probably not aware of their condition. The irony being that if they were aware and sought medical help for the condition they would not be treated for it because most doctors think it's not real.
I think what the article is saying is that if doctors recognized MCS as being real, they could prevent a lot of the illnesses that their patients come to them for. Since neither the patient nor the doctor recognized the true problem, the patients keep coming back again and again for treatment for all kinds of chronic conditions. It's one of those negative feedback loops. The medical community and the drug companies make money off of keeping people sick.

 

 
MCS
Posted by: SUSU23
Jul 26, 2012
i agree. There is no point in visiting the doctor with MCS complaints. They don't know anything about it and can't help you. There isn't a medication for it so they don't know what to do. if you get an illness from exposure, they can treat that. For myself, i work in an office where some of my co-workers are immature and feel that it is their right to wear perfume, spray airfreshner, etc, in the office. They are all aware of the problem but it seems to make them want to do it more. There are others in the office with the same problem but they won't speak up because they fear retaliation and unpopularity, lol.

 

 
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