Self-administration of adrenaline for anaphylaxis during in-hospital food challenges improves health-related quality of life.

ABSTRACT:

Objective

To assess the impact of anaphylaxis on health-related quality of life (HRQL) and self-efficacy in food-allergic patients undergoing in-hospital food challenge.

Design

Secondary analysis of a randomised controlled trial.

Setting

Specialist allergy centre.

Patients

Peanut-allergic young people aged 8-16 years.

Interventions

Double-blind, placebo-controlled food challenge to peanut, with HRQL and self-efficacy assessed using validated questionnaire, approximately 2 weeks prior to and 2 weeks after challenge. Where possible, anaphylaxis was treated with self-injected adrenaline (epinephrine).

Main outcome measures

Change in HRQL and self-efficacy.

Results

56 participants had reactions at food challenge, of whom 16 (29%) had anaphylaxis. Overall, there was an improvement in HRQL (mean 2.6 points (95% CI 0.3 to 4.8); p=0.030) and self-efficacy (mean 4.1 points (95% CI 2.4 to 5.9); p<0.0001), independent of whether anaphylaxis occurred. Parents also reported improved HRQL (mean 10.3 points (95% CI 5.9 to 14.7); p<0.0001). We found evidence of discordance between the improvement in HRQL and self-efficacy as reported by young people and that perceived by parents in their child.

Conclusions

Anaphylaxis at food challenge, followed by self-administration of injected adrenaline, was associated with an increase in HRQL and self-efficacy in young people with peanut allergy. We found no evidence that the occurrence of anaphylaxis had a detrimental effect. Young people should be encouraged to self-administer adrenaline using their autoinjector device to treat anaphylaxis at in-hospital challenge.

Trial registration number

NCT02149719.

SUBMITTER: Burrell S 

PROVIDER: S-EPMC8142442 | biostudies-literature | 2021 Jun

REPOSITORIES: biostudies-literature