Prescription Of epinephrine improves quality of life and reduces anxiety in food allergic children

Cummings, A., Knibb, R., Erlewyn-Lajeunesse, M., King, R.M., Roberts, G. and Lucas, A.J.S. (2009) Prescription Of epinephrine improves quality of life and reduces anxiety in food allergic children. Journal of Allergy and Clinical Immunology, 123 (2), S142. (doi:10.1016/j.jaci.2008.12.530).

Abstract

RATIONALE: Nut allergy is known to impact negatively on the QoL and anxiety of both the allergic child and the parents, but little is known about how the management of food allergy is associated with these variables.
METHODS: Forty-one nut allergic children (age 6-16 years) and their mothers completed questionnaires to assess maternal and children's quality of life (PedsQL™ or WHOQOL-BREF), anxiety (SCAS or STAI) and perceived stress (PSS). Children additionally completed a nut allergy specific QoL questionnaire. Demographic data, details of previous reactions, test results and management plans were collected using parent-report questionnaires and hospital notes. All families had received training from the specialist multidisciplinary team on recognition and management of allergic reactions and avoidance of allergens as part of their routine care.
RESULTS: Children with nut allergy had poorer emotional (p = 0.004), social (p = 0.043), and psychological (p = 0.006) QoL compared to healthy norm data. 35 children were prescribed adrenaline rescue medication. Management and health education was otherwise similar. Maternal and child reported anxiety was lower (p = 0.043 and p < 0.001 respectively) for children prescribed an adrenaline autoinjector. 29 children reported eating ‘may contain’ foods. Anxiety was not associated with whether the child carried the autoinjector or whether they strictly avoided traces of nuts in foods. Maternal and child QoL and anxiety were not influenced by the severity of previous reactions.
CONCLUSIONS: Prescribing autoinjectors may reduce anxiety for food allergic children and their mothers, but does not improve adherence with medical management or reduce risk taking behaviors.

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Contributors

Author: M. Erlewyn-Lajeunesse

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