New UA/Banner Health Valley fever clinical guidelines to help avoid delays in diagnosis
TUCSON, Ariz. – Arizona physicians often come to a delayed or incorrect diagnosis when seeing patients with newly acquired Valley fever infections — even though the respiratory fungal disease is very common in the state, particularly the corridor between Tucson and Phoenix.
This is because Valley fever's initial symptoms closely mirror those of the flu, resulting in antibiotics often being used to treat it initially instead of antifungals. Correcting the diagnosis and making the switch can take days or weeks, according to studies by the Arizona Department of Health Services and the U.S. Centers for Disease Control and Prevention.
Now, the University of Arizona Valley Fever Center for Excellence (VFCE) wants to do something about that. The center has teamed up with Banner Health to develop a Valley fever "clinical practice" guide, an agreed-upon set of rules for when primary care, urgent care and emergency department clinicians should do tests needed to detect Valley fever earlier.
"This guide is an expected result from the UA's medical faculties' merging their clinical care with that of Banner Health under the Banner – University Medicine Division that replaced the UA Health Network," said John N. Galgiani, MD, VFCE director, professor of medicine in the Division of Infectious Diseases at the UA Colleges of Medicine in Tucson and Phoenix, a member of the UA BIO5 Institute and medical director of the Banner – University Medicine Valley Fever Program. "Because of the merger, it provides a way for the center to help implement all best clinical practices it knows about for patients with Valley fever and actually employ them more broadly."
Developing the Valley fever clinical practice guidelines has been a yearlong planning process within the Clinical Consensus Group for primary care, Banner Health's program for guiding routine medical practices across its health-care sites. This clinical practice guide is earmarked especially for the ambulatory practices throughout the Phoenix, Casa Grande and Tucson metropolitan areas, where Valley fever is endemic.
Earlier this fall, a webinar for physicians was produced by Dr. Galgiani and David M. Valenzuela, MD, a Phoenix-area family practice physician, clinical assistant professor at the UA College of Medicine – Phoenix and the physician executive who heads Banner Medical Group Primary Care. The webinar is designed to give an overview of why Banner is rolling out the clinical practice guidelines and what they cover.
The webinar is available for viewing at https://streaming.biocom.arizona.edu/event/?id=28471 (PLEASE NOTE: In Google Chrome, Adobe Flash Player may be needed to view the video.)
"This clinical practice will change the way Arizona clinicians recognize and manage patients with Valley fever," Dr. Galgiani said. "Central to this change will be the expanded role of primary care clinicians in earlier diagnosis and management of uncomplicated infections."
To help physicians not yet familiar with this new clinical practice, Dr. Galgiani and Fariba Donovan, MD, PhD, an assistant professor in the UA Division of Infectious Diseases, research specialist with the VFCE and clinician with Banner – Univerity Medical Center Tucson, will hold training sessions at Banner clinical sites throughout the coming year.
While the clinical practice guidelines were developed within the Banner Health planning process, they also are being made available to clinicians outside of Banner programs so that these resources can be used throughout Arizona and beyond.
"Although Banner has taken this first step, there is no reason clinicians everywhere can't do the same thing," Dr. Galgiani said.
In 2018, Valley Fever Awareness Week, which has been declared annually by proclamation of the Arizona Office of the Governor since 2003, runs from Nov. 10 to Nov. 18.
About the UA Valley Fever Center for Excellence
In 1996, the Arizona Board of Regents established the Valley Fever Center for Excellence at the University of Arizona to address problems created by a fungus, Coccidioides, which is endemic to soils of the U.S. Southwest and is the cause of Valley fever. Some cases are mild; some so severe that it spreads past the lungs. It also affects animals, including pets and livestock. The center, which is affiliated with the UA Colleges of Medicine – Tucson and Phoenix through the UA Department of Medicine and Division of Infectious Diseases, works to spread public awareness and education about Valley fever, promote high-quality care for the disease and pursue research to improve treatment therapies and develop a vaccine. Learn more: vfce.arizona.edu
About Banner – University Medicine
Banner – University Medicine is the academic arm of nonprofit Banner Health — one of the largest nonprofit health-care systems in the country, with 28 hospitals in six states: Arizona, California, Colorado, Nebraska, Nevada and Wyoming. With a special emphasis on patient care, research and teaching, Banner – University Medicine includes Banner – University Medical Center Phoenix, Banner – UMC South, Banner – UMC Tucson, Banner Children's at Diamond Children's Medical Center, physician clinics and a physician practice plan.
About the University of Arizona Health Sciences
The University of Arizona Health Sciences is the statewide leader in biomedical research and health professions training. The UA Health Sciences includes the UA Colleges of Medicine (Phoenix and Tucson), Nursing, Pharmacy and Mel and Enid Zuckerman College of Public Health, with main campus locations in Tucson and the growing Phoenix Biomedical Campus in downtown Phoenix. From these vantage points, the UA Health Sciences reaches across the state of Arizona and the greater Southwest to provide cutting-edge health education, research, patient care and community outreach services. A major economic engine, the UA Health Sciences employs approximately 4,000 people, has approximately 800 faculty members and garners more than $140 million in research grants and contracts annually. For more information: uahs.arizona.edu