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Quality standards for allergen immunotherapy clinics in Spain. Consensus document

Tabar AI1, Núñez Acevedo B2, Beitia Mazuecos JM3, Fernández Ibáñez E4, Garde Garde J5, Hernández Fernández de Rojas D6, De Luque Piñana V7, Ojeda Fernández P8, Reaño Martos M9, Rodríguez Fernández F10, Roger Reig A11, Martínez JA12, Moreno Aguilar C13, Vidal C14

1Head of the Allergy Department. Complejo Hospitalario de Navarra. Chair of the SEAIC Immunotherapy Committee
2Allergy Specialist. Allergy Department, Hospital Infanta Sofía Madrid. Secretary of the SEAIC Immunotherapy Committee.
3Allergy Specialist. Hospital Universitario de Guadalajara. Guadalajara.
4Head of the Allergy Department. Hospital Universitario de Álava. Chair of the SEAIC Continuing Education Committee.
5Allergy and Paediatrics Specialist. Hospital General Universitario de Elche. Alicante.
6Head of the Allergy Department. Hospital Universitario La Fe. Valencia.
7Allergy Specialist. Hospital Universitario Virgen Macarena. Seville.
8Director, Clínica Ojeda. Madrid. Chair of the SEAIC Communication Committee.
9Allergy Specialist. Hospital Universitario Puerta de Hierro. Madrid. Chair of the SEAIC Quality and Safety Committee.
10Head of the Allergy Department. Hospital Universitario Marqués de Valdecilla. Associate Professor, School of Medicine. Universidad de Cantabria. Santander.
11Allergy Specialist. Director of the Allergy Unit. Hospital Universitari Germans Trias i Pujol de Badalona. Barcelona.
12Medical Advisor. GOC Networking.
13Head of the Allergy Clinical Management Unit. Hospital Universitario Reina Sofía. Córdoba.
14Head of the Allergy Department. Complejo Hospitalario Universitario de Santiago. Vice President of the SEAIC. 

J Investig Allergol Clin Immunol 2019; Vol. 29(4)
doi: 10.18176/jiaci.0318

Background: The allergen immunotherapy clinics (AITC) in Spain are very different in terms of structure, organisation, resources and portfolio of services. Therefore, it is essential to unify treatment criteria and define quality standards for the most complex AITCs.
Objective: To establish a series of recommendations that will make it possible to guarantee quality and safety in the administration of immunotherapy and to define the quality standards for the most complex AITCs.
Methods: This project began with an online survey of 65 allergy departments or units all over Spain conducted in 2013. Next, a two-phase consensus process was carried out. In the first, ten experts defined and agreed on the standards using the RAND/UCLA Appropriateness method; in the second, the agreements were validated by means of a Delphi consultation in two rounds to 84 experts.
Results: Consensus was reached on minimum safety and quality criteria in the administration of allergen immunotherapy (AIT), and two levels of highly complex AITCs were defined: accredited AITCs (AITCA) and AITCs accredited with excellence (AITCAE). Consensus was also reached on quality standards and accreditation criteria for both levels.
Conclusions: This project is pioneering in terms of its purpose - the definition of quality standards for AITCs - and for the use of structured participation techniques - a combination of the RAND/UCLA and Delphi methods. The results, together with some minimum standards for quality and safety in administering AIT, is a set of quality criteria for AITC accreditation supported by a broad panel of SEAIC experts.

Key words: Allergens, Delphi Study, Immunotherapy, Health Care Quality Assurance