Medical clown support is associated with better quality of life of children with food allergy starting oral immunotherapy.

Abstract

The start of oral immunotherapy (OIT) for food allergy is a critical period in the treatment process, with a potential to influence patient quality of life (QOL) and subsequently treatment outcome. The association of medical clowning with QOL at OIT initiation was examined. Children aged 4-12years supported by a medical clown (MC) during the induction week of OIT for food allergy were studied. Children in the same age range starting OIT without the support of a MC served as controls. Parents of all children completed the Food Allergy Quality of Life Questionnaire-Parent Form (FAQLQ-PF), and children aged 8-12years completed the Food Allergy Quality of Life Questionnaire-Child Form (FAQLQ-CF). QOL scores of parents and children with and without a MC support were compared. Children with (n=88) and without (n=212) the support of a MC were comparable in demographics and clinical characteristics. The study group had a significantly lower single highest tolerated dose compared to controls (57±83 vs 162±274mg protein, respectively, P<.001). Parental perception of the QOL of children was not associated with a MC support (P=.81) but rather with previous reaction severity (P<.01). In contrast, the QOL of children aged 8-12years (n=119) was positively associated primarily with a MC support, total score 3.7±1.1 vs 4.6±1.3 (P<.001). While the perception of QOL of parents of children with food allergy at OIT initiation is mainly associated with previous reaction severity, the QOL of the children themselves is primarily positively associated with MC support.