DIAGNOSIS AND MANAGEMENT OF FOOD ALLERGIC PATIENTS ACROSS SEVERITY AND ALLERGENS: A NATIONWIDE US SURVEY

Abstract

<h3>Introduction</h3> Food allergies affect millions of Americans and may result in life-threatening outcomes. In this study we aimed to understand food allergy diagnosis and management patterns of US Allergists. <h3>Methods</h3> In November 2021, a nationwide survey was emailed to US-practicing allergists (N=2850) to determine their diagnosis and management patterns. Providers were screened to ensure management of at least 1 food-allergic patient per month, with >25% of patients representing a pediatric population. <h3>Results</h3> The survey was completed by 125 allergists; the majority of allergists (81%) were community practitioners who saw an average of 74 food-allergic patients per month, of which 58% were pediatric. Allergists' top priorities for managing patients included preventing serious allergic reactions and maximizing patients' quality of life. Only 40% of allergists rate the severity of food allergies in their patients: main factors to determine disease severity were the severity/type of symptoms, history of requiring intervention (epinephrine), and number of organ systems involved in the reaction following exposure. Less important factors were skin prick test wheal size, presence of comorbid allergic diseases, and impact on quality of life. <h3>Conclusion</h3> Among US-based allergists that manage food-allergic patients, preventing serious allergic reactions was a top priority. Less than half of allergists categorize food allergy severity, and reaction severity weighs predominantly in how the overall disease severity is characterized. Further research on the impact of how definitions of food allergy disease severity impact shared decision making is warranted.