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Liu K, Wang S, Li Z, Xia Y, Chen Q. Psychometric properties of disease-specific health-related quality of life instruments for food allergy: A COnsensus-based Standards for the selection of health Measurement INstruments-based systematic review. Pediatr Allergy Immunol 2024; 35:e14165. [PMID: 38822738 DOI: 10.1111/pai.14165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 05/06/2024] [Accepted: 05/13/2024] [Indexed: 06/03/2024]
Abstract
Food allergies severely impact the health-related quality of life (HRQoL) of patients and their caregivers (family or informal caregivers). Currently there is no comprehensive review to provide an overview and critical assessment of the instruments in the field. Six databases were searched from inception until 10 August 2023, and a combination of subject terms and free words was used to search the literature. We used the COnsensus-based Standards for the selection of health Measurement INstruments methodology (COSMIN) to evaluate the measurement properties of the instruments. Forty-one studies reported on ten eligible instruments. Based on COSMIN guidelines, one instrument was recommended for Grade A, and the remaining nine instruments were recommended for Grade B. The Grade A instrument identified, the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF), can help researchers assess the effectiveness of treatment for patients with food allergy and to understand the psychosocial impact of the disease on patients.
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Affiliation(s)
- Ke Liu
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Shuyi Wang
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zeen Li
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Yuting Xia
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Qirong Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
- Xiangya Center for Evidence-Based Nursing Practice & Healthcare Innovation: A JBI Centre of Excellence, Central South University, Changsha, Hunan, China
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2
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Rosser SA, Lloyd M, Hu A, Loke P, Tang MLK. Associations between gender and health-related quality of life in people with IgE-mediated food allergy and their caregivers: A systematic review. Clin Exp Allergy 2024; 54:93-108. [PMID: 38321912 DOI: 10.1111/cea.14450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 12/21/2023] [Accepted: 01/03/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVE Understanding factors that impact health-related quality of life (HRQL) is essential to inform personalised food allergy management. However, there are inconsistencies about the impact of gender on HRQL in food allergy. This review aimed to collate all investigations of the association between gender and total or subdomain HRQL scores of individuals with food allergy and their caregivers. DESIGN This is a narrative systematic review. We descriptively synthesised and compared HRQL outcomes by participant and parent genders according to statistical and clinical significance. Study quality was assessed using the ROBINS-I, inclusive of all domains. Sensitivity analysis of non-interventional studies was conducted using the ROBINS-E. DATA SOURCES A systematic search of Medline and Embase databases was conducted on 4 April 2022 and updated on 5 December 2023. ELIGIBILITY CRITERIA Studies were eligible for inclusion if they reported original data on the association between any sex and/or gender and HRQL, as measured with any validated instrument, in populations with IgE-mediated food allergy. Interventional and non-interventional studies were eligible. RESULTS A comparison of 34 eligible studies (10 interventional and 24 non-interventional) indicated females with food allergy (62.5% of studies of children, 83.3% of studies of adults) and mothers of children with food allergy (50% of studies of caregivers) experienced poorer self-reported baseline HRQL than their counterparts, notably in domains of physical, emotional or food anxiety-related well-being. Gender differences in child HRQL after food allergen immunotherapy were observed. However, selective reporting in included interventional studies meant the direction of this association could not be determined. The proxy-reported total HRQL of participants was not affected by caregiver gender, nor was caregiver HRQL likely impacted by child gender. CONCLUSIONS Gender should be considered an important modifier of participant HRQL outcomes in food allergy studies. Purposeful exploration of HRQL in all genders is needed to fully understand the implications of this construct on the lived experience of food allergy. SYSTEMATIC REVIEW REGISTRATION PROSPERO (CRD42022329901).
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Affiliation(s)
- Sophie A Rosser
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- National Allergy Centre of Excellence (NACE), Parkville, Victoria, Australia
| | - Melanie Lloyd
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Centre for Medicine Use and Safety, Monash University, Parkville, Victoria, Australia
| | - Alice Hu
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Paxton Loke
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Victoria, Australia
- Monash Children's Hospital, Monash Health, Clayton, Victoria, Australia
| | - Mimi L K Tang
- Allergy Immunology, Murdoch Children's Research Institute, Parkville, Victoria, Australia
- Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
- Department of Allergy and Immunology, The Royal Children's Hospital, Parkville, Victoria, Australia
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Lee S. Assessment of Quality of Life in Food Allergy. ALLERGY, ASTHMA & IMMUNOLOGY RESEARCH 2023; 15:4-7. [PMID: 36693353 PMCID: PMC9880303 DOI: 10.4168/aair.2023.15.1.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 12/30/2022] [Accepted: 12/30/2022] [Indexed: 01/20/2023]
Affiliation(s)
- Sooyoung Lee
- Department of Pediatrics, Ajou University School of Medicine and Graduate School of Medicine, Suwon, Korea
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Proctor KB, Tison K, Estrem H, Park J, Scahill L, Vickery BP, Sharp WG. A systematic review of parent report measures assessing the psychosocial impact of food allergy on patients and families. Allergy 2022; 77:1347-1359. [PMID: 34647344 DOI: 10.1111/all.15140] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/10/2021] [Accepted: 10/10/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Reducing the psychosocial impact of food allergy (FA) represents a top patient-centered research priority. This priority recognizes that psychosocial impact is an important outcome of current FA therapies (eg, oral immunotherapy), as well as interventions aimed at improving overall quality of life and illness adaptation. Reliable and valid measurement is a necessary prerequisite to developing and evaluating current and emerging FA therapies and potential changes in psychosocial impact. METHODS In this systematic review, we applied the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement to evaluate available parent report measures assessing the psychosocial impact of pediatric IgE-mediated FA. RESULTS The systematic search yielded 64 articles involving 13 unique measures. Measures were evaluated through the lens of the Patient Reported Outcomes Measurement Information System (PROMIS) guidelines. Findings indicated that available measures show some evidence of reliability and validity; however, none completely adhere to PROMIS guidelines for measure development. CONCLUSION Results highlight a continued need to dedicate research to develop a measurement approach that assesses the full range of psychosocial impact that parents and families may experience as a result of FA, as well as serve as a research outcome as the field continues to develop effective treatments, including immunotherapy.
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Affiliation(s)
| | | | - Hayley Estrem
- University of North Carolina Wilmington Wilmington NC USA
| | | | - Lawrence Scahill
- Children’s Healthcare of Atlanta Atlanta GA USA
- Emory University Atlanta GA USA
| | - Brian P. Vickery
- Children’s Healthcare of Atlanta Atlanta GA USA
- Emory University Atlanta GA USA
| | - William G. Sharp
- Children’s Healthcare of Atlanta Atlanta GA USA
- Emory University Atlanta GA USA
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Peters RL, Eigenmann P. Editorial comments on: "The burden of food allergy on children and teens: A systematic review". Pediatr Allergy Immunol 2022; 33:e13742. [PMID: 35338738 DOI: 10.1111/pai.13742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 02/02/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Rachel L Peters
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, The University of Melbourne, Parkville, Victoria, Australia
| | - Philippe Eigenmann
- Department of Pediatrics, Gynecology and Obstetrics, University Hospital of Geneva, Geneva, Switzerland
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Adaptation, Translation and Validation of the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF): The Malay Version. CHILDREN 2021; 8:children8111050. [PMID: 34828763 PMCID: PMC8617718 DOI: 10.3390/children8111050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 11/16/2022]
Abstract
Food allergy has a significant impact on the quality of life (QoL) of children and can be measured using The Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF). This study aimed to adapt, translate the FAQLQ-PF into Malay and determine the validity and reliability of the translated version. This cross-sectional questionnaire validation study was conducted among parents of children (0 to 12 years old) with food allergies across five sites in Selangor and Kuala Lumpur, Malaysia. The FAQLQ-PF-Malay underwent cross-cultural adaptation, translation, validation (content, face and construct) and reliability assessment. Exploratory factor analysis, internal consistency and test-retest reliability analyses were used to examine its construct validity and reliability. Out of 150 children, the majority were between the age of 7 to 12 years old (41%) and were female (81%). Three subscales were identified, which were: (i) social and dietary implication, (ii) food anxiety and (iii) emotional and physical impact. Four items were eliminated because of weak factor loadings. The Cronbach’s alpha for each subscale ranged from 0.88 to 0.94, with an overall Cronbach’s alpha of 0.95. The intra-class correlation coefficient ranged from 0.54 (95% CI: 0.10–0.77) to 0.97 (95% CI: 0.90–0.99). The 26-item FAQLQ-PF-Malay retained the three-factor structure of the original FAQLQ-PF. The FAQLQ-PF-Malay is a valid and reliable tool to assess the QoL of Malaysian children with food allergies.
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Lieberman JA, Gupta RS, Knibb RC, Haselkorn T, Tilles S, Mack DP, Pouessel G. The global burden of illness of peanut allergy: A comprehensive literature review. Allergy 2021; 76:1367-1384. [PMID: 33216994 PMCID: PMC8247890 DOI: 10.1111/all.14666] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 10/30/2020] [Accepted: 11/14/2020] [Indexed: 01/05/2023]
Abstract
Peanut allergy (PA) currently affects approximately 2% of the general population of Western nations and may be increasing in prevalence. Patients with PA and their families/caregivers bear a considerable burden of self‐management to avoid accidental peanut exposure and to administer emergency medication (adrenaline) if needed. Compared with other food allergies, PA is associated with higher rates of accidental exposure, severe reactions and potentially fatal anaphylaxis. Approximately 7%–14% of patients with PA experience accidental peanut exposure annually, and one‐third to one‐half may experience anaphylaxis, although fatalities are rare. These risks impose considerably high healthcare utilization and economic costs for patients with PA and restrictions on daily activities. Measures to accommodate patients with PA are often inadequate, with inconsistent standards for food labelling and inadequate safety policies in public establishments such as restaurants and schools. Children with PA are often bullied, resulting in sadness, humiliation and anxiety. These factors cumulatively contribute to significantly reduced health‐related quality of life for patients with PA and families/caregivers. Such factors also provide essential context for risk/benefit assessments of new PA therapies. This narrative review comprehensively assessed the various factors comprising the burden of PA.
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Affiliation(s)
- Jay A. Lieberman
- University of Tennessee Health Science Center/Le Bonheur Children’s Hospital Memphis TN USA
| | - Ruchi S Gupta
- Institute for Public Health and Medicine Ann & Robert H. Lurie Children's Hospital of ChicagoNorthwestern School of Medicine Chicago IL USA
| | | | | | | | - Douglas P. Mack
- Department of Pediatrics McMaster University Hamilton ON Canada
| | - Guillaume Pouessel
- Pneumology and Allergology Unit Children's HospitalLille University Hospital Jeanne de Flandre France
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8
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Reier-Nilsen T, Carlsen KCL, Michelsen MM, Drottning S, Carlsen KH, Zhang C, Borres MP, Håland G. Parent and child perception of quality of life in a randomized controlled peanut oral immunotherapy trial. Pediatr Allergy Immunol 2019; 30:638-645. [PMID: 31013372 DOI: 10.1111/pai.13066] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 04/12/2019] [Accepted: 04/15/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Improved quality of life (QoL) after oral immunotherapy (OIT) in peanut allergic children is often reported by their parents, while the child's perspective is less clear. OBJECTIVE We aimed to explore whether 2 years of OIT improved QoL in children with peanut allergy and to identify factors influencing change in QoL. METHODS In the open-labeled TAKE-AWAY peanut OIT trial including children with anaphylaxis to peanuts, 57 were randomized to OIT and 20 to observation. The Pediatric Quality of Life Inventory Version 4.0 was completed by parents and children at enrollment (Y0 ), after 1 year (end of updosing; Y1 ) and after 2 years (Y2 ) of OIT. Minimally clinically important difference (MCID) is ≥5.3. Perceived treatment burden was recorded by visual analogue scales, including adverse events (AEs). An open food challenge (OFC) was performed at Y2 . RESULTS At Y2 , 18 children had discontinued OIT and 2 of 39 OIT children refused OFC, while 35 of 37 were desensitized to 7500 mg peanut protein. From Y0 to Y2, the mean change (95% confidence intervals) in QoL was 4.4 (0.5, 8.3) among child self-reports and twice as large among parental proxy reports (9.3 [4.3, 14.3]; both P < 0.0001), without significant improvement among the controls. The change in QoL was significantly different from the controls for the parental proxy reports only (P = 0.002). Neither treatment burden nor AEs significantly predicted changes in QoL. CONCLUSION Two years of OIT improved child-QoL as reported by parents, but not by the children, suggesting that parents may overestimate improvement in child-QoL by OIT.
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Affiliation(s)
- Tonje Reier-Nilsen
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Karin C Lødrup Carlsen
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Merethe Melbye Michelsen
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sebastian Drottning
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
| | - Kai-Håkon Carlsen
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Chi Zhang
- Department of Biostatistics, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Magnus P Borres
- Thermo-Fisher Scientific, Uppsala, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Geir Håland
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Preliminary psychometric analyses and clinical performance of a caregiver self-efficacy scale for food allergy self-management. Ann Allergy Asthma Immunol 2019; 120:73-79. [PMID: 29273132 DOI: 10.1016/j.anai.2017.09.060] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 09/11/2017] [Accepted: 09/18/2017] [Indexed: 11/22/2022]
Abstract
BACKGROUND Food allergy health-related quality of life has been defined, but self-efficacy is poorly described. OBJECTIVE To examine the preliminary reliability, validity, and clinical performance of a novel food allergy self-efficacy index. METHODS An 8-item Food Allergy Self-Efficacy Questionnaire (FASEQ) was adapted for food allergy-related themes and coadministered with the Food Allergy Quality of Life Parental Burden (FAQL-PB) index to caregivers self-reporting a food allergic child (group A) and those with children followed up at a food allergy referral center clinic (group B). FASEQ split-half reliability, 2-week recall, factor analysis, and construct and discriminative validity were assessed. Multiple linear regression was used to explore predictive associations between the FAQL-PB and the FASEQ. RESULTS Among 2,308 caregivers, the mean FASEQ score was 2.69 (95% CI, 2.66-2.73) and was lower (better) among group A (mean FASEQ score, 2.52; 95% CI, 2.49-2.56) vs group B (mean FASEQ score, 3.75; 95% CI, 3.66-3.84; P < .001). The FASEQ Cronbach α was 0.87, and the 2-week intraclass correlation coefficient (ICC) was 0.75. Total and 6 of 8 individual FASEQ domain scores were significantly lower among caregivers with children having anaphylaxis or epinephrine use vs none and peanut or tree nut allergy vs milk or egg allergy, demonstrating good discriminative validity. Total FASEQ score was associated with FAQL-PB score (ICC, 0.13; 95% CI, 0.06-0.19; P < .001), with 6 of 8 FASEQ individual domains significantly associated (ICC range, -0.17 to 0.3; P < .01 for all). Factor analysis revealed 2 domains (medical care and social functioning) with construct validity. CONCLUSION We present preliminary evidence the FASEQ is a valid tool to assess caregiver food allergy self-efficacy. Self-efficacy is a distinct but related concept that captures aspects of self-management that are an important companion to health-related quality of life.
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11
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Bartoll E, Nieto M, Selva B, Badillo R, Pereira G, Uixera S, Nieto A, Mazón Á. Validation of a Spanish version of the EuroPrevall Food Allergy Quality of Life Questionnaire-Parental Form. Allergol Immunopathol (Madr) 2018; 46:82-86. [PMID: 29033200 DOI: 10.1016/j.aller.2017.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2017] [Revised: 06/07/2017] [Accepted: 06/21/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Food allergy can have a major impact on quality of life of children and their parents. Questionnaires have been developed to measure the impact of this disorder. We aimed to validate the EuroPrevall questionnaire on Food Allergy-Quality of Life Questionnaire, Parent Form (FAQLQ-PF) and the Food Allergy Independent Measure (FAIM), translated into Spanish. METHODS The internal consistency of the FAQLQ-PF and the FAIM, translated into Spanish (Spain) and completed by the parents of 74 children with IgE-mediated food allergy, were evaluated with Cronbach's alpha. To test construct validity of the FAQLQ-PF, its correlation with the FAIM was also calculated. To assess their discriminant validity, we compared the values of both depending on the number of offending foods and for children with and without anaphylaxis. RESULTS The values of Cronbach's alpha for the three domains in the FAQLQ-PF were over 0.9. The value of alpha for FAIM questions was below 0.6, which was attributed to the wording of one question. When this question was removed, alpha increased to over 0.70. There was a significant correlation between the FAQLQ-PF score and the FAIM. There were significantly poorer FAQLQ-PF scores in children with more food allergies and worse FAIM in those who had had anaphylaxis. CONCLUSIONS The Spanish version of the FAQLQ-PF had a good internal consistency, good construct validity and validity to discriminate patients with more food allergies and anaphylaxis. It can be used as a tool to evaluate and monitor the quality of life in families with food allergic children.
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Sánchez-García S, Cipriani F, Ricci G. Food Allergy in childhood: phenotypes, prevention and treatment. Pediatr Allergy Immunol 2015; 26:711-20. [PMID: 26595763 DOI: 10.1111/pai.12514] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/16/2015] [Indexed: 12/30/2022]
Abstract
The prevalence of food allergy in childhood increased in the last decades, especially in Westernized countries where this phenomenon has been indicated as a second wave of the allergic epidemic. In parallel, scientific interest also increased with the effort to explain the reasons of this sudden rise and to identify potential protective and risk factors. A great attention has been focused on early exposures to allergenic foods, as well as on other nutritional factors or supplements that may influence the immune system in a positive direction. Both interventions on maternal diet before birth or during breastfeeding and then directly on infant nutrition have been investigated. Furthermore, the natural history of food allergy also seems to be changing over time; IgE-mediated cow's milk allergy and egg allergy seem to be more frequently a persistent rather than a transient disease in childhood, as described in the last years. Food avoidance and the emergency drugs in case of an adverse event, such as epinephrine self-injector, are currently the first-line treatment in patients with food allergies, with a resulting impairment in the quality of life and social behaviour. During the last decade, oral immunotherapy emerged as an optional treatment with remarkable results, offering a novel perspective in the treatment for and management of food allergy.
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Affiliation(s)
| | - Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
| | - Giampaolo Ricci
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Knibb RC, Barnes C, Stalker C. Parental confidence in managing food allergy: development and validation of the food allergy self-efficacy scale for parents (FASE-P). Clin Exp Allergy 2015. [DOI: 10.1111/cea.12599] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- R. C. Knibb
- Psychology; School of Life and Health Sciences; Aston University; Birmingham UK
| | - C. Barnes
- Psychology; College of Life and Natural Sciences; University of Derby; Derby UK
| | - C. Stalker
- Psychology; College of Life and Natural Sciences; University of Derby; Derby UK
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14
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Chow C, Pincus DB, Comer JS. Pediatric Food Allergies and Psychosocial Functioning: Examining the Potential Moderating Roles of Maternal Distress and Overprotection. J Pediatr Psychol 2015; 40:1065-74. [PMID: 26089553 DOI: 10.1093/jpepsy/jsv058] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2014] [Accepted: 05/19/2015] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Identify factors associated with maternal perceptions of health-related quality of life (QoL) among youth with food allergies (FA), and identify maternal factors that may moderate relationships between FA-related challenges and child QoL. METHODS In all, 533 mothers of children with FA completed measures assessing characteristics of their child's FA, maternal perceptions of child QoL, maternal psychological distress, and maternal overprotection. RESULTS FA severity, maternal psychological distress, and overprotection were significantly associated with maternal reports of poorer child functioning and/or poorer QoL among youth with FA. Hierarchical linear regression analyses showed an FA severity by maternal distress interaction in the prediction of child FA-related anxiety; children of higher stress mothers showed a stronger link between auto-injector use and anxiety than children of lower stress mothers. CONCLUSIONS When identifying youth with FA who are at risk for low QoL, it is important to assess history of FA-related challenges, parental psychological distress, and overprotection.
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Affiliation(s)
- Candice Chow
- Division of Pediatric Psychosocial Oncology, Dana-Farber Cancer Institute, Harvard Medical School,
| | - Donna B Pincus
- Department of Psychology, Center for Anxiety and Related Disorders (CARD), Boston University, and
| | - Jonathan S Comer
- Mental Health Interventions and Technology (MINT) Program, Florida International University
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15
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Greenhawt M. Food allergy quality of life. Ann Allergy Asthma Immunol 2014; 113:506-12. [PMID: 25442694 DOI: 10.1016/j.anai.2014.06.027] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 06/24/2014] [Accepted: 06/25/2014] [Indexed: 12/12/2022]
Affiliation(s)
- Matthew Greenhawt
- The University of Michigan Food Allergy Center, Division of Allergy and Clinical Immunology, University of Michigan Health System, Ann Arbor, Michigan; Department of Pediatrics, Division of General Pediatrics, Child Health Evaluation and Research Unit, University of Michigan Health System, Ann Arbor, Michigan.
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Cipriani F, Dondi A, Ricci G. Recent advances in epidemiology and prevention of atopic eczema. Pediatr Allergy Immunol 2014; 25:630-8. [PMID: 25406640 DOI: 10.1111/pai.12309] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/14/2014] [Indexed: 12/22/2022]
Abstract
Atopic dermatitis (AD), named also atopic eczema, is a chronic relapsing inflammatory skin disease with a considerable social and economic burden. The primum movens of AD is in most cases a genetic and/or immune-supported defect of the skin barrier, facilitating penetration and sensitization to food or airborne allergens, as well as infections by Staphylococcus aureus, herpes simplex virus, or other microbes. New pathogenetic concepts have generated new approaches to prevention and therapy of AD. In particular, the daily use of emollients in newborns at high risk of AD has shown interesting results, with a reduction in the cumulative incidence of AD ranging from 32% to 50% of the treated infants. On the other hand, the AD preventive efficacy of food and/or inhalant allergen avoidance has been questioned, and supplementation strategies (vitamin D, probiotics, or other compounds) need to be further investigated.
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Affiliation(s)
- Francesca Cipriani
- Pediatric Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
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Salvilla SA, Dubois AEJ, Flokstra-de Blok BMJ, Panesar SS, Worth A, Patel S, Muraro A, Halken S, Hoffmann-Sommergruber K, DunnGalvin A, Hourihane JO, Regent L, de Jong NW, Roberts G, Sheikh A. Disease-specific health-related quality of life instruments for IgE-mediated food allergy. Allergy 2014; 69:834-44. [PMID: 24836207 DOI: 10.1111/all.12427] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/28/2022]
Abstract
This is one of seven interlinked systematic reviews undertaken on behalf of the European Academy of Allergy and Clinical Immunology as part of their Guidelines for Food Allergy and Anaphylaxis, which focuses on instruments developed for IgE-mediated food allergy. Disease-specific questionnaires are significantly more sensitive than generic ones in measuring the response to interventions or future treatments, as well as estimating the general burden of food allergy. The aim of this systematic review was therefore to identify which disease-specific, validated instruments can be employed to enable assessment of the impact of, and investigations and interventions for, IgE-mediated food allergy on health-related quality of life (HRQL). Using a sensitive search strategy, we searched seven electronic bibliographic databases to identify disease-specific quality of life (QOL) tools relating to IgE-mediated food allergy. From the 17 eligible studies, we identified seven disease-specific HRQL instruments, which were then subjected to detailed quality appraisal. This revealed that these instruments have undergone formal development and validation processes, and have robust psychometric properties, and therefore provide a robust means of establishing the impact of food allergy on QOL. Suitable instruments are now available for use in children, adolescents, parents/caregivers, and adults. Further work must continue to develop a clinical minimal important difference for food allergy and for making these instruments available in a wider range of European languages.
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Affiliation(s)
- S. A. Salvilla
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. E. J. Dubois
- Department of Pediatric Pulmonology and Pediatric Allergy; GRIAC Research Institute; University of Groningen; University Medical Center Groningen; Groningen the Netherlands
| | - B. M. J. Flokstra-de Blok
- Department of General Practice; GRIAC Research Institute; University of Groningen; University Medical Centre Groningen; Groningen the Netherlands
| | - S. S. Panesar
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. Worth
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - S. Patel
- St. George's University; Cranmer Terrace; London UK
| | - A. Muraro
- Padua General University Hospital; Padua Italy
| | - S. Halken
- Odense University Hospital; Odense C Denmark
| | - K. Hoffmann-Sommergruber
- Department of Pathophysiology and Allergy Research; Medical University of Vienna; Vienna Austria
| | - A. DunnGalvin
- Department of Paediatrics and Child Health; University College; Cork Ireland
| | - J. O’B. Hourihane
- Department of Paediatrics and Child Health; University College; Cork Ireland
| | - L. Regent
- The Anaphylaxis Campaign; Farnborough Hampshire UK
| | - N. W. de Jong
- Department of Internal Medicine; Section Allergology; ErasmusMC; Rotterdam the Netherlands
| | - G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Newport Isle of Wight
- NIHR Southampton Respiratory Biomedical Research Unit; University of Southampton and University Hospital Southampton NHS Foundation Trust
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - A. Sheikh
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
- Division of General Internal Medicine and Primary Care; Brigham and Women's Hospital/Harvard Medical School; Boston MA USA
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Muraro A, Dubois AEJ, DunnGalvin A, Hourihane JO, de Jong NW, Meyer R, Panesar SS, Roberts G, Salvilla S, Sheikh A, Worth A, Flokstra-de Blok BMJ. EAACI Food Allergy and Anaphylaxis Guidelines. Food allergy health-related quality of life measures. Allergy 2014; 69:845-53. [PMID: 24785644 DOI: 10.1111/all.12405] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2014] [Indexed: 12/17/2022]
Abstract
Instruments have been developed and validated for the measurement of health-related quality of life in patients with food allergy. This guideline has been prepared by the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines for Food Allergy and Anaphylaxis Group. It draws on a systematic review of the literature on quality of life instruments for food allergy and the Appraisal of Guidelines for Research & Evaluation (AGREE II) guideline development process. Guidance is provided on the use of such instruments in research, and the current limitations of their use in clinical practice are described. Gaps in current knowledge as well as areas of future interest are also discussed. This document is relevant to healthcare workers dealing with food-allergic patients, scientists engaging in food allergy research and policy makers involved in regulatory aspects concerning food allergy and safety.
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Affiliation(s)
- A. Muraro
- Department of Mother and Child Health; The Referral Centre for Food Allergy Diagnosis and Treatment Veneto Region; University of Padua; Padua Italy
| | - A. E. J. Dubois
- Department of Pediatric Pulmonology and Pediatric Allergy; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- GRIAC Research Institute; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
| | - A. DunnGalvin
- Department of Pediatrics and Child Health; School of Applied Psychology; School of Medicine; University College Cork; Cork Ireland
| | - J. O'B. Hourihane
- Department of Paediatrics and Child Health; University College Cork; Cork Ireland
| | - N. W. de Jong
- Department of Internal Medicine; Section of Allergology; Erasmus MC; Rotterdam the Netherlands
| | - R. Meyer
- Department Gastroenterology; Great Ormond Street Hospital for Sick Children; London UK
| | - S. S. Panesar
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - G. Roberts
- David Hide Asthma and Allergy Research Centre; St Mary's Hospital; Isle of Wight UK
- NIHR Respiratory Biomedical Research Unit; University Hospital Southampton NHS Foundation Trust and University of Southampton Faculty of Medicine; Southampton UK
- Human Development and Health Academic Unit; Faculty of Medicine; University of Southampton; Southampton UK
| | - S. Salvilla
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - A. Sheikh
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
- Division of General Internal Medicine and Primary Care; Brigham and Women's Hospital/Harvard Medical School; Boston MA USA
| | - A. Worth
- Allergy & Respiratory Research Group; Centre for Population Health Sciences; The University of Edinburgh; Edinburgh UK
| | - B. M. J. Flokstra-de Blok
- GRIAC Research Institute; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
- Department of General Practice; University Medical Center Groningen; University of Groningen; Groningen the Netherlands
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van der Velde JL, Dubois AEJ, Flokstra-de Blok BMJ. Food allergy and quality of life: what have we learned? Curr Allergy Asthma Rep 2014; 13:651-61. [PMID: 24122150 DOI: 10.1007/s11882-013-0391-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Health-related quality of life (HRQL) has become an emerging focus of interest in food allergy. Food allergy is a disease characterized by low mortality and symptoms which only occur during an allergic reaction. However, food-allergic patients continuously need to be alert when eating in order to prevent potentially severe allergic reactions, which may be fatal. Fear of such reactions and the need to be continuously vigilant may seriously compromise their HRQL. During the last decade, numerous studies have been published on food allergy and HRQL. The development of reliable, valid and responsive instruments for measuring HRQL in food allergic patients has facilitated this research even further. Such instruments have given insight into the specific problems a patient may face and the impact of food allergy-related interventions from the patient's perspective. This paper focuses on the most significant findings regarding this topic since its first appearance in the literature in 2000.
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Knibb RC, Semper H. Impact of suspected food allergy on emotional distress and family life of parents prior to allergy diagnosis. Pediatr Allergy Immunol 2013; 24:798-803. [PMID: 24329879 DOI: 10.1111/pai.12176] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/05/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Food allergy is associated with psychological distress in both child and parent. It is unknown whether parental distress is present prior to clinical diagnosis or whether experiences at clinic can reduce any distress present. This study aimed to assess anxiety and depression in parents and the impact of suspected food allergy on the lives of families before and after a visit to an allergy clinic. METHODS One hundred and twenty-four parents visiting an allergy clinic for the first time to have their child assessed for food allergy completed a study-specific questionnaire and the Hospital Anxiety and Depression Scale; 50 parents completed these 4-6 wk later in their own home. RESULTS Most parents (86.4%) reported suspected food allergy had an impact on their family life prior to clinic attendance; 76% had made changes to their child's diet. 32.5% of parents had mild-to-severe anxiety before their clinic visit; 17.5% had mild-to-moderate depression. Post-clinic, 40% had mild-to-severe anxiety; 13.1% had mild-to-moderate depression. There were no significant differences in anxiety (p = 0.34) or depression scores (p = 0.09) before and after the clinic visit. CONCLUSIONS Anxiety and depression is present in a small proportion of parents prior to diagnosis of food allergy in their child and this does not reduce in the short term after the clinic visit. Identification of parents at risk of suffering from distress is needed and ways in which we communicate allergy information before and at clinic should be investigated to see if we can reduce distress.
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Cortes A, Castillo A, Sciaraffia A. Development of the scale of psychosocial factors in food allergy (SPS-FA). Pediatr Allergy Immunol 2013; 24:671-7. [PMID: 24028435 DOI: 10.1111/pai.12123] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/21/2013] [Indexed: 11/30/2022]
Abstract
BACKGROUND Food allergy (FA) is a growing condition among children and it's psychological impact over the patients and their caregivers is well known, establishing a vicious circle that perpetuates stress levels. However, psychosocial factors are not commonly included in allergy treatments. Based on the lack of evidence of records about a scale that indicates the level of interaction between biopsychosocial factors in the patient-caregivers dyad for FA, the present research aims to develop a scale with these characteristics as a helpful tool to achieve a more comprehensive system of health care. METHODS A preliminary 28-item scale was generated (sample N = 99). The scale was adjusted in contents and language after expert opinion and application on patients. A factor analysis was carried out selecting the items from the final scale. RESULTS The final 9-item scale included three areas: impact on quality of life, social impact and conflicts. The scale had a good internal consistency (Cronbach's α = 0.870) and correlated significantly with anxiety and depression measurements. Moreover, it was able to discriminate between study groups (members and non-members of peer support groups) and proved construct validity. CONCLUSIONS The SPS-FA is the first scale for the assessment of the interaction of biopsychosocial factors on FA that includes the patient-caregiver dyad. Its application might be relevant for future research, and it can provide the clinician and the researcher with a solid tool to define which type of psychosocial support is required to provide a more comprehensive care in FA.
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Affiliation(s)
- Aaron Cortes
- Section of Immunology, HIV and Allergy, Hospital Clínico Universidad de Chile, Santiago, Chile
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