Familiarity with oral immunotherapy for food allergy varies by race, ethnicity
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LOUISVILLE, Ky. — Familiarity with oral immunotherapy as treatment for food allergy significantly varies by race and ethnicity, according to a presentation at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
However, the reasons for not participating in OIT are largely similar between non-Hispanic white and non-Hispanic Black participants, Neil Thivalapill, MS, a data analyst at the Center for Food Allergy & Asthma Research, said during his presentation.
“OIT represents another tool in the arsenal that can be offered to patients with select food allergies,” said Thivalapill, who also is a medical student at the Northwestern University Feinberg School of Medicine.
“In order to inform patient education and outreach efforts for this relatively new treatment strategy, we need a better understanding of the patient’s knowledge, attitudes and experiences regarding OIT,” Thivalapill continued.
In 2019, the researchers administered a questionnaire to parents and caregivers in the FORWARD study of children with food allergies. Among the 259 responses that were analyzed, 28.6% were from non-Hispanic Black participants and 71.4% were from non-Hispanic white participants.
The overall average age at enrollment was 6 years. Non-Hispanic Black children were on average older than non-Hispanic white children (6.9 vs. 5.6 years; P = .007).
Overall, 9.7% of non-Hispanic white respondents and 23% of non-Hispanic Black participants said that they were not familiar at all with OIT, which the researchers called a statistically significant difference (P = .003).
Sixteen respondents (6.2%) said that they had a child currently participating in OIT, with another 23 (8.9%) planning to start OIT when the survey was administered.
“Among the remaining 243 participants who did not start OIT, we found the most common reason for why their child was not currently receiving OIT was that their health care provider never discussed OIT as a treatment option,” Thivalapill said.
Specifically, 69 respondents (28.4%) said their provider had never discussed OIT as a treatment option, including 52 (30.2%) non-Hispanic white respondents and 17 (23.9%) non-Hispanic Black respondents.
Next, 43 respondents (17.7%), including 32 (18.6%) non-Hispanic white and 11 (15.5%) non-Hispanic Black respondents, said they were not participating in OIT because their child was allergic to multiple foods.
Also, 28 respondents (11.5%), including 16 (9.3%) non-Hispanic white and 12 (16.9%) non-Hispanic Black respondents, had never heard of OIT before receiving the survey.
Inconvenience in scheduling and traveling to appointments was cited by 27 respondents (11.1%), including 20 (11.6%) non-Hispanic white respondents and seven (9.9%) non-Hispanic Black respondents.
Respondents also said that they were not sure that their child would benefit from OIT (n = 26; 10.7%), they were not sure that they or their child could accept the risks of OIT (n = 22; 9.1%) or they needed to see more information about OIT (n = 21; 8.6%).
Additional reasons included a lack of recommendation from professional medical organizations and/or patient groups (n = 20; 8.2%), a preference for avoiding the allergen (n = 18; 7.4%), requirements for multiple health care provider office visits (n = 16; 6.6%) and high costs or lack of insurance coverage (n = 14; 5.8%).
“Familiarity with OIT may differ significantly between race and ethnicity, but the reasons for not participating in OIT are largely similar between non-Hispanic white and non-Hispanic Black participants,” Thivalapill said.
Institutional barriers such as providers who do not discuss OIT as an option for therapy with their patients and patient-level factors such as the inconvenience of multiple appointments and multiple food allergies all likely contribute to low uptake of OIT, Thivalapill continued.
“We believe that this study suggests that increasing patient education regarding the efficacy, safety, indications, as well as the cost of OIT may result in a more equitable and increased awareness of this treatment strategy,” he said.