ABSTRACT
Introduction: In January 2020, Peanut (Arachis hypogaea) Allergen Powder-dnfp (PTAH) became the first treatment for Peanut Allergy (PA) approved by the US Food and Drug Administration (FDA). The adoption of innovative new therapies requires consideration of the skills, logistics and practicalities required for implementation. Methods: Qualitative interviews were conducted to explore health care providers’ (HCPs) experiences of delivering PTAH, challenges encountered, and successful implementation strategies. HCPs who had initiated PTAH treatment with ≥3 patients since FDA approval were eligible. Semi-structured interviews were conducted via videoconference. Interviews were audio-recorded, transcribed, and analyzed using content analysis. The study was exempted by the Western Institutional Review Board. Results: Eight allergists and three nurse practitioners participated. Their experiences are characterized by four key themes: 1. factors influencing adoption, 2. factors related to delivering the treatment in everyday practice, 3. learnings and reflections, and 4. delivering PTAH during the COVID-19 pandemic. HCPs described how successful implementation of PTAH requires them to be thoughtful about their clinic’s abilities to integrate complex, time-consuming treatments into their practice. Prior experience of oral immunotherapy was deemed beneficial, but not essential for implementation and learning from others’ experience was suggested as a way of helping new prescribers overcome perceived and actual implementation challenges. Conclusion: The experiences described by the treatment pioneers included in this research serve to benefit the wider allergy community by providing practical solutions, successful implementation strategies and opportunities to share information as new innovative treatments become available to patients.