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Anagnostou A, Yaworsky A, Brova M, Ibrahim N, Kakked S, Spite S, Duluc L, Shields AL, Lee T, Leonard S, Przywara K, Smith A. Evaluation and Modification of a Shared Decision-Making Tool for Peanut Allergy Management. Curr Allergy Asthma Rep 2024:10.1007/s11882-024-01146-w. [PMID: 38639896 DOI: 10.1007/s11882-024-01146-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2024] [Indexed: 04/20/2024]
Abstract
PURPOSE OF REVIEW Based on shared decision-making (SDM) principles, a decision aid was previously developed to help patients, their caregivers, and physicians decide which peanut allergy management approach best suits them. This study refined the decision aid's content to better reflect patients' and caregivers' lived experience. RECENT FINDINGS Current standard of care for peanut allergy is avoidance, although peanut oral immunotherapy has been approved by the Food and Drug Administration for use in patients 4-17 years old. An advisory board of allergy therapy experts (n = 3) and patient advocates (n = 3) informed modifications to the decision aid. The revised tool underwent cognitive debriefing interviews (CDIs) among adolescents (12-17 years old) with peanut allergy and caregivers of patients 4-17 years old with peanut allergy to evaluate its relevance, understandability, and usefulness. The 20 CDI participants understood the information presented in the SDM tool and reported it was important and relevant. Some revisions were made based on participant feedback. Results support content validity of the Peanut Allergy Treatment SDM Tool.
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Affiliation(s)
| | - Andrew Yaworsky
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA.
| | - Monica Brova
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA
| | - Nazifa Ibrahim
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA
| | - Siddharth Kakked
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA
| | - Sasha Spite
- California State University San Marcos, San Marcos, CA, USA
| | - Linette Duluc
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA
| | - Alan L Shields
- Adelphi Values, One Lincoln Street, Suite 2400, Boston, MA, 02111, USA
| | - Tricia Lee
- Emory University School of Medicine, Children's Healthcare of Atlanta, Atlanta, GA, USA
- American College of Allergy, Asthma, and Immunology, Arlington Heights, IL, USA
| | - Stephanie Leonard
- University of California San Diego, San Diego, CA, USA
- Rady Children's Hospital, San Diego, CA, USA
| | - Kathy Przywara
- Asthma and Allergy Foundation of America, Arlington, VA, USA
| | - Amelia Smith
- Food Allergy and Anaphylaxis Connection Team, Liberty Twp, OH, USA
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Venter C, Sicherer SH, Greenhawt M. Management of Peanut Allergy. J Allergy Clin Immunol Pract 2020; 7:345-355.e2. [PMID: 30717865 DOI: 10.1016/j.jaip.2018.10.043] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 10/22/2018] [Accepted: 10/23/2018] [Indexed: 01/14/2023]
Abstract
Peanut allergy is a growing public health concern in westernized countries. Peanut allergy is characterized as an often severe and lifelong allergy, which can have detrimental effects on quality of life and trigger anxiety. Although multiple therapeutic options are emerging, the focus of current management strategies is strict peanut avoidance and carriage of self-injectable epinephrine. The greatest risk of reacting to peanut comes from direct ingestion, whereas casual skin contact or airborne exposure is highly unlikely to provoke significant symptoms. Patients and families must be educated about how to best execute strict peanut avoidance through careful label reading as well as how to understand and address likely and unlikely risk with regard to peanut exposure in public, in particular when dining outside of the home and for children attending school or child care. This review discusses the risk of exposure in public such as at school or on an airplane and how such risk can be abated, situations and scenarios when dining out of the house that may pose more risks than others, the essentials of US and EU label reading laws with particular emphasis on precautionary labeling and the risk implied by such, quality of life and psychosocial issues that may affect the peanut allergic individual and family, and a discussion of how risk may differ and evolve based on the patient's age.
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Affiliation(s)
- Carina Venter
- Section of Allergy and Immunology, Children's Hospital Colorado, Food Challenge and Research Unit, University of Colorado School of Medicine, Aurora, Colo; The David Hide Asthma and Allergy Research Centre, Newport, Isle of Wight, United Kingdom.
| | - Scott H Sicherer
- Division of Pediatric Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai and the Jafee Food Allergy Institute, New York, NY
| | - Matthew Greenhawt
- Section of Allergy and Immunology, Children's Hospital Colorado, Food Challenge and Research Unit, University of Colorado School of Medicine, Aurora, Colo
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