PHYSICIAN DIAGNOSIS OF ADULT FOOD ALLERGY

Abstract

Introduction Food allergy (FA) is a life-threatening health condition that continues to increase in prevalence, yet knowledge regarding diagnosis and management of adult FA is limited. As a result, the objective of this study is to describe physician diagnostic practices of FA in adults. Methods A survey was administered via web and telephone to a sample of US households between 2015-2016, providing parent parent-proxy responses for 40,443 adults. Stringent symptom criteria were developed with FA experts to distinguish respondents with “convincing” FA from those with similar conditions. Post stratification-weighted proportions were estimated to compare FA diagnosis characteristics by allergy type. Results Approximately 50% (95% CI: 48.6-51.9) of convincing adult FA were not diagnosed by a physician. Physician diagnosis was significantly higher for males, adults with seasonal allergy, severe FA, and multiple FA. In families that earned less than $50,000, adults were significantly less likely to receive a physician diagnosis, whereas in families that earned between $50,000 and $100,000, adults were more likely to receive a physician diagnosis. Of physician-diagnosed FA, 70.2% (95% CI: is 67.9-72.5) were evaluated with a skin prick test, 47.4% (95% CI: 44.9-49.8) with an IgE test, and 30.3% (95% CI: 28.1-32.6) with an oral food challenge. Conclusions Adults with convincing FA are not frequently receiving physician diagnoses. This suggests a higher perceived burden of FA that may result in unnecessary avoidance of food. and impaired quality of life.