Matthew Greenhawt1, Rebekah Marsh2, Hannah Gilbert3, Scott Sicherer4, Audrey DunnGalvin5, Dan Matlock6. 1. Children's Hospital Colorado, University of Colorado School of Medicine, Section of Allergy and Immunology, Aurora, Colorado. Electronic address: Matthew.Greenhawt@childrenscolorado.org. 2. Department of Pediatrics, University of Colorado School of Medicine, Adult and Child Consortium for Health Outcomes Research and Delivery Science (ACCORDS), Aurora, Colorado. 3. Children's Hospital Colorado, University of Colorado School of Medicine, Section of Allergy and Immunology, Aurora, Colorado. 4. Division of Pediatric Allergy and Immunology, Department of Pediatrics, The Icahn School of Medicine at Mount Sinai, New York, New York. 5. Department of Paediatrics, University College Cork, Cork, Ireland. 6. Department of Medicine, Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, Colorado; Veterans Affairs Eastern Colorado Geriatric Research Education and Clinical Center, Denver, Colorado.
Abstract
BACKGROUND: Both oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT) are emerging potential treatments for peanut allergy. Caregiver goals and expectations of these therapies are poorly defined. OBJECTIVE: To determine caregiver goals and expectations of food allergy therapy. METHODS: Twenty-two detailed, semistructured interviews of OIT and EPIT caregivers were conducted, allowing caregivers to describe their motivations for and experiences with food allergy therapy and life with a peanut allergic child. RESULTS: In this sample, caregivers of peanut allergic children enrolled in OIT or EPIT phase 3 trials expressed a primary goal for their child to develop a buffer against an unintentional peanut exposure. The perception of the buffer varied, representing a decreased reaction severity on exposure, increased time to react to allow for assessment, or increased threshold of peanut exposure tolerated. Although caregivers expressed that a buffer may increase their confidence in travel and dining outside the home, they do not anticipate this buffer would lessen their overall level of pretherapy anxiety, allergen-associated vigilance, or avoidance practices. Most of the caregivers hope the buffer will increase their and their child's perceived sense of freedom for the child's actions and social interactions, translating to quality of life improvement, while still respecting the limitations of having a severe allergy that has been partially treated. No caregiver viewed these therapies as a cure, and most viewed treatment as a supplement to their current avoidance practices. CONCLUSION: Caregivers of peanut allergic children strongly desire that OIT and EPIT result in a buffer against an unintentional reaction, although most admitted that this would not significantly change their anxiety and family's current lifestyle.
BACKGROUND: Both oral immunotherapy (OIT) and epicutaneous immunotherapy (EPIT) are emerging potential treatments for peanutallergy. Caregiver goals and expectations of these therapies are poorly defined. OBJECTIVE: To determine caregiver goals and expectations of food allergy therapy. METHODS: Twenty-two detailed, semistructured interviews of OIT and EPIT caregivers were conducted, allowing caregivers to describe their motivations for and experiences with food allergy therapy and life with a peanut allergic child. RESULTS: In this sample, caregivers of peanut allergic children enrolled in OIT or EPIT phase 3 trials expressed a primary goal for their child to develop a buffer against an unintentional peanut exposure. The perception of the buffer varied, representing a decreased reaction severity on exposure, increased time to react to allow for assessment, or increased threshold of peanut exposure tolerated. Although caregivers expressed that a buffer may increase their confidence in travel and dining outside the home, they do not anticipate this buffer would lessen their overall level of pretherapy anxiety, allergen-associated vigilance, or avoidance practices. Most of the caregivers hope the buffer will increase their and their child's perceived sense of freedom for the child's actions and social interactions, translating to quality of life improvement, while still respecting the limitations of having a severe allergy that has been partially treated. No caregiver viewed these therapies as a cure, and most viewed treatment as a supplement to their current avoidance practices. CONCLUSION: Caregivers of peanut allergic children strongly desire that OIT and EPIT result in a buffer against an unintentional reaction, although most admitted that this would not significantly change their anxiety and family's current lifestyle.
Authors: David M Fleischer; Matthew Greenhawt; Gordon Sussman; Philippe Bégin; Anna Nowak-Wegrzyn; Daniel Petroni; Kirsten Beyer; Terri Brown-Whitehorn; Jacques Hebert; Jonathan O'B Hourihane; Dianne E Campbell; Stephanie Leonard; R Sharon Chinthrajah; Jacqueline A Pongracic; Stacie M Jones; Lars Lange; Hey Chong; Todd D Green; Robert Wood; Amarjit Cheema; Susan L Prescott; Peter Smith; William Yang; Edmond S Chan; Aideen Byrne; Amal Assa'ad; J Andrew Bird; Edwin H Kim; Lynda Schneider; Carla M Davis; Bruce J Lanser; Romain Lambert; Wayne Shreffler Journal: JAMA Date: 2019-03-12 Impact factor: 56.272
Authors: Laura Polloni; Antonella Muraro; Roberta Bonaguro; Alice Toniolo; Anna Ballin; Alberto Guarnaccia; Francesca Lazzarotto Journal: Clin Transl Allergy Date: 2022-02-03 Impact factor: 5.871
Authors: P Bégin; E S Chan; H Kim; M Wagner; M S Cellier; C Favron-Godbout; E M Abrams; M Ben-Shoshan; S B Cameron; S Carr; D Fischer; A Haynes; S Kapur; M N Primeau; J Upton; T K Vander Leek; M M Goetghebeur Journal: Allergy Asthma Clin Immunol Date: 2020-03-18 Impact factor: 3.406