Caregiver perceptions of when to offer an oral food challenge for children with food allergy

Abstract

Food allergy (FA) is a rising public health concern, affecting up to 5% of the pediatric population. 1 Sicherer S.H. Sampson H.A. Food allergy: epidemiology, pathogenesis, diagnosis, and treatment. J Allergy Clin Immunol. 2014; 133: 291-307 Abstract Full Text Full Text PDF PubMed Scopus (967) Google Scholar Oral food challenges (OFCs) are the gold standard for diagnosing FA. 2 Bindslev-Jensen C. Ballmer-Weber B.K. Bengtsson U. et al. Standardization of food challenges in patients with immediate reactions to foods—position paper from the European Academy of Allergology and Clinical Immunology. Allergy. 2004; 59: 690-697 Crossref PubMed Scopus (585) Google Scholar Although the decision to undergo an OFC is multifactorial, current guidelines suggest considering an OFC when the likelihood of passing the challenge is approximately 50%. 3 Nowak-Węgrzyn Assa'ad A.H. Bahna S.L. et al. Work Group report: oral food challenge testing. Adverse Reactions to Food Committee of the American Academy of Allergy. Asthma & Immunology. 2009; 123: S365-S383 Scopus (446) Google Scholar Prior studies have shown that performing an OFC is associated with better quality of life (QOL) among caregivers of individuals with FA and reduced parental burden of FA, regardless of challenge outcome. 4 Franxman T.J. Howe L. Teich E. Greenhawt M.J. Oral food challenge and food allergy quality of life in caregivers of children with food allergy. J Allergy Clin Immunol. 2015; 3: 50-56 Scopus (42) Google Scholar , 5 Kansen H.M. Le T.M. Meijer Y. et al. The impact of oral food challenges for food allergy on quality of life: a systematic review. Pediatr Allergy Immunol. 2018; 29: 527-537 Crossref PubMed Scopus (32) Google Scholar Others have reported that maternal anxiety regarding allergic reactions decreases after children pass an OFC. 6 Herbert L.J. Dahlquist L.M. Bollinger M.E. Maternal intolerance of uncertainty, anxiety, and adherence with food challenge referrals. J Health Psychol. 2013; 18: 1209-1219 Google Scholar When caregivers believe it is appropriate to undergo an OFC and whether they are conflicted about that decision is unclear. The aim of our study was to gain further understanding of caregiver knowledge, perceptions, and comfort level participating in OFCs.