Specialist care improves diagnosis and treatment for patients with chronic spontaneous urticaria: A real-world survey.

Background: Although effective treatments and guidelines for chronic spontaneous urticaria (CSU) are available, patients often experience diagnostic delays and undertreatment. Objective: Our aim was to assess diagnostic differences and receipt of biologic treatment in patients with CSU across physician specialties. Methods: Data from the Adelphi Real World CSU Disease-Specific Programme survey of physicians, including specialists (allergists/immunologists [n = 49] and dermatologists [n = 51]) and primary care physicians (PCPs) (n = 20), and their consulting patients with CSU (n = 1082) (United States, December 2020-October 2021) were analyzed. Logistic and Cox proportional hazard regressions were used to assess associations between outcomes and physician specialty. Results: CSU was most often diagnosed by a specialist, even though the physician whom most patients consulted first was a PCP. The median time to diagnosis was shorter for specialists than for PCPs: patients who first consulted a PCP were more likely to experience a delay to CSU diagnosis than were patients who first consulted a specialist (odds ratio for an allergist/immunologist = 4.89 [ Conclusion: For patients with CSU, consultation with an allergist/immunologist or dermatologist versus with a PCP was associated with faster time to CSU diagnosis and guideline-recommended treatment with omalizumab. This is the first study providing clear evidence that patients with CSU would benefit from specialist consultation.