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Few PCPs ‘proficient’ in early peanut introduction

Only 12% of primary care physicians surveyed correctly answered all the questions regarding early peanut introduction, according to findings presented at the American College of Allergy, Asthma and Immunology Annual Scientific Meeting.

“As first line clinicians, PCPs have an important role in the prevention of food allergy. ... By identifying knowledge gaps, we can target future interventions to improve practical application of the guidelines,” researchers wrote.

They presented a series of clinical presentation scenarios to 138 PCPs within one hospital.

In addition to those 12% who answered all the questions correctly, 17% of the PCPs answered four of the five questions correctly. Of the 67% who reported confidence in applying NIH guidelines regarding early peanut introduction, only 18% of these participants answered all the scenarios correctly, and 15% answered four of the scenarios correctly.

“The findings suggest that most PCPs are not proficient in applying the NIH recommendations regarding early peanut introduction. PCPs would likely benefit from further education regarding the current guidelines,” researchers wrote.

In 2017, the National Institute of Allergy and Infectious Diseases — a division of the NIH — announced that an expert panel had developed guidelines that, along with LEAP study data, showed that introducing peanut-containing foods early may reduce the risk for allergy

According to the NIAID, the LEAP study “clearly showed that introduction of peanut early in life significantly lowered the risk of developing peanut allergy by age 5.” Other data from LEAP indicated that early introduction of peanut maintained a reduction in the prevalence of peanut allergy despite 12 months of peanut avoidance.

The expert panel’s guidelines recommend parents and clinicians introduce peanut-containing foods to infants after they have begun consuming solid foods in descending order of allergy risk. Specifically:

• Infants at high-risk for developing peanut allergy due to a diagnosis of severe eczema or egg allergy be introduced to peanut-containing foods at 4 to 6 months to reduce development risk;
• Infants at moderate risk due to a diagnosis of mild or moderate eczema should be introduced to peanut-containing foods at 6 months to reduce the risk for peanut allergy; and
• Infants without a diagnosis of eczema or food allergy should be introduced to peanut-containing foods at any time.

The recommendations can also be found on NIAID’s website.

Reference:

Mehta P, et al. Early peanut introduction in the primary care setting. Presented at: American College of Allergy, Asthma and Immunology Annual Scientific Meeting; Nov. 15-19, 2018; Seattle.

Disclosures: Please see the meeting’s abstract book for those authors’ relevant financial disclosures.