Oral food challenge and food allergy quality of life in caregivers of children with food allergy

Abstract

Background: Food allergy is associated with diminished patient and caregiver quality of life (QoL). Although oral food challenge (OFC) improves QoL of individuals with food allergy, its effects on caregiver QoL are unknown.

Objectives: To determine if differences in caregiver QoL exist based on their child undergoing OFC.

Methods: Caregivers of individuals with food allergy who underwent OFCs between 2001 and 2012 at the University of Michigan Food Allergy Center completed the Food Allergy Quality of Life-Parental Burden index and a questionnaire that assessed details of the most-severe reaction by an individual with food allergy. Results were compared with 305 caregivers of individuals with food allergy who were unchallenged. All questionnaire data regarding the characteristics of the reactions of individuals with food allergy were verified through chart review.

Results: A total of 115 caregivers of individuals with food allergy who were undergoing OFC completed the QoL assessment. Caregivers of individuals with food allergy who were undergoing OFC had a significantly lower (better) QoL score than controls who were not challenged (1.5 vs 1.88; P = .02). Furthermore, within the challenged cohort, there was no significant difference in QoL score between those with a passing OFC (eg, non-reactive) and a failing OFC (eg, reactive) (1.42 vs 1.34; P = .83). In an adjusted linear regression model, the QoL score was significantly better among caregivers of individuals with food allergy who were undergoing OFC and with an income >$50,000 but significantly worsened for caregivers with multiple individuals with food allergy or if the individual with food allergy had atopic dermatitis.

Conclusion: The caregiver QoL score is better with individuals with food allergy who underwent OFC versus controls who were unchallenged but not significantly different based on OFC outcome. QoL is, in addition, moderated by income, the presence of atopic dermatitis, and having multiple individuals with food allergy. OFC is associated with better caregiver QoL, irrespective of challenge outcome.

Keywords: Caregivers; Food allergy; Health services research; Oral food challenge; Quality of life.

Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Figures

Figure 1

Study Flow Diagram

Figure 2. Comparison of Mean Caregiver QoL Scores Among Challenged vs. Unchallenged Children

Comparison of caregiver quality of life based on their food allergic child undergoing oral food challenge (n=305 not challenged; n=115 challenged) and the outcome of that challenge (n=99 pass; n=16 fail). Error bars indicate standard error. Lower score indicates better quality of life.

Figure 3. Comparison of Mean Caregiver QoL Scores Stratified by Allergen

Comparison of caregiver quality of life based on their food allergic child undergoing oral food challenge, stratified by allergen type (egg n=23; milk n=42; peanut n=42; tree nut n=8). Error bars indicate standard error. Lower score indicates better quality of life.