ABSTRACT
Food protein-induced enterocolitis (FPIES) is a non-IgE cell- mediated food allergy that can be severe and lead to shock. Despite the potential seriousness of reactions, awareness of FPIES is low; high-quality studies providing insight into the pathophysiology, diagnosis, and management are lacking; and clinical outcomes are poorly established. This consensus document is the result of work done by an international workgroup convened through the Adverse Reactions to Foods Committee of the American Academy of Allergy, Asthma & Immunology and the International FPIES Association advocacy group. These are the first international evidence-based guidelines to improve the diagnosis and management of patients with FPIES. Research on prevalence, pathophysiology, diagnostic markers, and future treatments is necessary to improve the care of patients with FPIES. These guidelines will be updated periodically as more evidence becomes available.
Subject(s)
Dietary Proteins/adverse effects , Enterocolitis/diagnosis , Enterocolitis/therapy , Food Hypersensitivity/diagnosis , Food Hypersensitivity/therapy , Dietary Proteins/immunology , Enterocolitis/immunology , Food Hypersensitivity/complications , HumansABSTRACT
OBJECTIVE: To develop and validate a food allergy educational program. STUDY DESIGN: Materials developed through focus groups and parental and expert review were submitted to 60 parents of newly referred children with a prior food allergy diagnosis and an epinephrine autoinjector. The main outcome was correct demonstration of an autoinjector. RESULTS: The correct number of autoinjector activation steps increased from 3.4 to 5.95 (of 6) after training (P < .001) and was 5.47 at 1 year (P < .05). The mean score for comfort with using the autoinjector (7-point Likert scale) before the curriculum was 4.63 (somewhat comfortable) and increased to 6.23 after the intervention (P < .05) and remained elevated at 1 year (6.03). Knowledge tests (maximum 15) increased from a mean score of 9.2 to 12.4 (P < .001) at the initial visit and remained at 12.7 at 1 year. The annualized rate of allergic reactions fell from 1.77 (historical) the year prior, to 0.42 (P < .001) after the program. On a 7-point Likert scale, all satisfaction categories remained above a favorable mean score of 6: straight-forward, organized, interesting, relevant, and recommend to others. CONCLUSIONS: This food allergy educational curriculum for parents, now available online at no cost, showed high levels of satisfaction and efficacy.
Subject(s)
Epinephrine/administration & dosage , Family , Food Hypersensitivity/drug therapy , Patient Education as Topic/methods , Adolescent , Child , Child, Preschool , Humans , Infant , Surveys and QuestionnairesABSTRACT
OBJECTIVE: To determine pediatric dietitians' self-reported proficiency, educational needs, and preferences regarding food allergy (FA) management. DESIGN AND SETTING: An Internet-based, anonymous survey was distributed to the Pediatric Nutrition Practice Group (PNPG) of the American Dietetic Association. PARTICIPANTS: Respondents (n = 311) were registered dietitians and members of the PNPG. ANALYSIS: Results are presented using descriptive statistics. Chi-square tests were applied for subgroup analyses. Percentage responses were calculated per question based on the number of respondents answering the question. RESULTS: On a 4-point scale of proficiency ("high," "moderate," "low," and "none"), respondents primarily rated themselves "moderate" for educating families, creating diets, and evaluating safe food items, and "low" for creating diagnostic food challenges. Education was primarily self-taught (75%). Preferences for future resources included handbooks (77%) and Web-based instructional programs (53%). On a 4-point scale ("very" to "not at all" needed) among practices that included >10% patients with FA, ratings of "very" were defined as need resources to update FA knowledge (87%) and need for a FA "tool kit" (84%). CONCLUSIONS AND IMPLICATIONS: Pediatric dietitians manage FA for a substantial patient base although their self-reported proficiency is overall only moderate. Dietitians would prefer and likely benefit from Internet-accessible management handbooks and patient handouts.
