Finnish nationwide allergy programme 2008–2018 changed attitudes and reduced morbidity
Introduction In Finland (population 5.5 million), a 10-year national programme to prevent and treat allergic diseases was initiated in 2008. The programme changed from an avoidance strategy to a tolerance strategy, focused on severe clinical manifestations and emphasised health instead of allergy. The overall aim was to reduce the burden of allergies.
Methods Six goals for healthcare were set, and for each of them specific tasks, tools and outcome evaluations were stipulated. A large-scale educational programme for both healthcare professionals and the lay public followed. During the 10 years, 24 000 healthcare workers took part in 276 educational sessions. Internet and social media were effectively employed to contact people.
Results In 10 years, the prevalence of allergy and asthma levelled off. Asthma caused fewer symptoms and less disability, and 50% fewer hospital days. Food allergy diets in day care and schools were halved. Occupational allergies decreased by 45%. Emergency visits due to anaphylaxis increased, which was expected due to intensive education improving awareness. In diagnostics, molecular IgE-testing was employed effectively and skin prick testing centralized. Altogether, the total yearly costs of allergy and asthma were reduced by €200 million (30%), when comparing the years 2007 and 2018.
Conclusions The Finnish real-life, long-term intervention indicated that attitudes can be changed, allergy prevented, and costs reduced. Revisiting the allergy paradigm and systematic education markedly reduced the public health burden of these common disorders.