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Pediatrician adherence to food allergy guidelines varies widely
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LOS ANGELES — Pediatrician adherence to published best practice guidelines for the diagnosis and management of food allergies varied widely between specific recommendations, according to data presented at the 2016 American Academy of Allergy, Asthma & Immunology annual meeting.
“The role of the primary care provider vs. that of the pediatric allergist, in the diagnosis and management of pediatric food allergy, has not been well-defined,” Alana Otto, MD, of the Ann & Robert H. Lurie Children’s Hospital of Chicago, told Infectious Diseases in Children. “Improving partnerships and role delineation between primary care pediatricians and allergists is critical to improving food allergy management and outcomes.”
Alana Otto
The researchers studied the medical records of 123 children aged younger than 18 years from three urban pediatric practices. Study participants were included if they were diagnosed with a food allergy from 2012 to 2015. The researchers determined how closely pediatricians followed National Institute of Allergy and Infectious Diseases’ guidelines by examining if they documented clinical allergy history, performed diagnostic testing, prescribed injectable epinephrine, provided caregiver counseling, or referred patients to an allergist.
Study data indicated that the most common allergies among participants were related to egg (22%) and tree nut (17%). The researchers found that pediatricians documented clinical allergy history in 99% of cases. Likewise, caregiver counseling was given in 70% of instances, and epinephrine injectors were prescribed to 67% of participants. Allergen-specific IgE was ordered in 24% of patients, and emergency action plans also were documented in only 24% of patients. Pediatricians referred 68% of study participants to an allergist for further treatment.
Ruchi S. Gupta
“Working to make sure pediatricians are comfortable diagnosing food allergy and prescribing and teaching families on how and when to treat with epinephrine is critical,” Ruchi S. Gupta, MD, MPH, associate professor of pediatrics at Northwestern University Feinberg School of Medicine, told Infectious Diseases in Children. “Giving families an action plan and referring to an allergist are also key steps.” – by David Costill
Reference:
Otto A, et al. Abstract 270. Presented at: the American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.
Disclosure: The researchers report no relevant financial disclosures.