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

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dc.contributor.authorBurrell, Sarah
dc.contributor.authorPatel, Nandinee
dc.contributor.authorVazquez-Ortiz, Marta
dc.contributor.authorCampbell, Dianne E.
dc.contributor.authorDunnGalvin, Audrey
dc.contributor.authorTurner, Paul J.
dc.contributor.funderMedical Research Councilen
dc.contributor.funderEuropean Commissionen
dc.contributor.funderNational Institute for Health and Care Researchen
dc.date.accessioned2022-09-13T15:31:08Z
dc.date.available2022-09-13T15:31:08Z
dc.date.issued2021-09-18
dc.date.updated2022-09-13T15:15:04Z
dc.description.abstractObjective: 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.en
dc.description.sponsorshipMedical Research Council (reference MR/K010468/1); National Institute for Health and Care Research (Biomedical Research Centre)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationBurrell, S., Patel, N., Vazquez-Ortiz, M., Campbell, D. E., DunnGalvin, A. and Turner, P. J. (2021) 'Self-administration of adrenaline for anaphylaxis during in-hospital food challenges improves health-related quality of life', Archives of Disease in Childhood, 106(6), pp. 558-563. doi: 10.1136/archdischild-2020-319906en
dc.identifier.doi10.1136/archdischild-2020-319906en
dc.identifier.eissn1468-2044
dc.identifier.endpage563en
dc.identifier.issn0003-9888
dc.identifier.issued6en
dc.identifier.journaltitleArchives of Disease in Childhooden
dc.identifier.startpage558en
dc.identifier.urihttps://hdl.handle.net/10468/13598
dc.identifier.volume106en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.projectinfo:eu-repo/grantAgreement/EC/H2020::MSCA-IF-EF-ST/656878/EU/Improving the safety of oral immunotherapy for cow's milk allergy in children/SO-CMAen
dc.rights© 2021, the Authors. Re-use permitted under CC BY. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made.en
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/en
dc.subjectAllergy qualityen
dc.subjectDouble-blinden
dc.subjectEuropean Academyen
dc.subjectChildrenen
dc.subjectAdolescentsen
dc.subjectPrevalenceen
dc.subjectEfficacyen
dc.subjectRisken
dc.subjectQuestionnaireen
dc.subjectValidationen
dc.titleSelf-administration of adrenaline for anaphylaxis during in-hospital food challenges improves health-related quality of lifeen
dc.typeArticle (peer-reviewed)en
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