Abstract
The Allergy to Peanuts imPacting Emotions And Life study (APPEAL) explored the psychosocial burden of living with self-reported peanut allergy experienced by children, teenagers, adults and caregivers in the UK and Ireland. A two-stage (quantitative survey and qualitative interview [APPEAL-1]), cross-sectional study of the psychosocial burden of peanut allergy (APPEAL-2) was conducted. Quantitative data were evaluated using descriptive statistics and qualitative data were analysed using MAXQDA software. A conceptual model specific to UK and Ireland was developed using the concepts identified during the analysis. A total of 284 adults in the UK and Ireland completed the APPEAL-1 survey and 42 individuals participated in APPEAL-2. Respondents reported that peanut allergy restricts their choices in various situations, especially with regard to choosing food when eating out (87% moderately or severely restricted), choosing where to eat (82%), special occasions (76%) and when buying food from a shop (71%). Fifty-two percent of survey participants and 40% of interview participants reported being bullied because of PA. Psychological impact of peanut allergy included feeling at least moderate levels of frustration (70%), uncertainty (79%), and stress (71%). The qualitative analysis identified three different types of coping strategies (daily monitoring or vigilance, communication and planning) and four main areas of individuals' lives that are impacted by peanut allergy (social activities, relationships, emotions and work [adults and caregivers only]). The extent of the impact reported varied substantially between participants, with some reporting many negative consequences of living with peanut allergy and others feeling it has minimal impact on their health-related quality of life. This large survey and interview study highlight the psychosocial burden of peanut allergy for adults, teenagers, children and caregivers in the UK and Ireland. The analysis demonstrates the wide variation in level of impact of peanut allergy and the unmet need for those individuals who experience a substantial burden from living with peanut allergy.
Highlights
In the UK and Ireland peanut allergy (PA) is the third most common food allergy, affecting between 0.5–2.5% of children [1,2,3,4,5] and up to 0.5% of adults [6]
Variation in level of impact of peanut allergy and the unmet need for those individuals who experience a substantial burden from living with peanut allergy
The results from the full APPEAL study showed the psychosocial burden of PA in Europe [20, 21]; this study provides an in-depth view of the results specific to the UK and Ireland and adds to previous research conducted in these countries
Summary
In the UK and Ireland peanut allergy (PA) is the third most common food allergy, affecting between 0.5–2.5% of children [1,2,3,4,5] and up to 0.5% of adults [6]. Recent research using validated instruments (Food Allergy Quality of Life Questionnaire; Food Allergy Independent Measure; EQ-5D) to assess the impact of PA on the HRQL of children and teenagers in the UK found that caregivers report high levels of psychosocial burden for their child, those with more severe PA and a recent history of reactions. Given the lack of UK and Ireland evidence relating to PA rather than food allergies in general, this article highlights the burden experienced by children, teenagers, adults and caregivers in the UK and Ireland to this most common of persistent food allergies
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