食物过敏儿童的照料者的口服食物激发试验及食物过敏生活质量
Oral food challenge and food allergy quality of life in caregivers of children with food allergy.
作者信息
Franxman Timothy J, Howe Laura, Teich Esther, Greenhawt Matthew J
机构信息
The University of Michigan Food Allergy Center and the Division of Allergy and Clinical Immunology, University of Michigan Health System, University of Michigan Medical School, Ann Arbor, Mich; Family Allergy and Asthma, Florence, Ky.
The University of Michigan Food Allergy Center and the Division of Allergy and Clinical Immunology, University of Michigan Health System, University of Michigan Medical School, Ann Arbor, Mich.
出版信息
J Allergy Clin Immunol Pract. 2015 Jan-Feb;3(1):50-6. doi: 10.1016/j.jaip.2014.06.016. Epub 2014 Aug 29.
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.
背景
食物过敏与患者及照料者的生活质量（QoL）下降有关。尽管口服食物激发试验（OFC）可改善食物过敏个体的生活质量，但其对照料者生活质量的影响尚不清楚。
目的
确定基于其孩子是否接受口服食物激发试验，照料者的生活质量是否存在差异。
方法
2001年至2012年期间在密歇根大学食物过敏中心接受口服食物激发试验的食物过敏个体的照料者，完成了食物过敏生活质量-父母负担指数以及一份评估食物过敏个体最严重反应细节的问卷。将结果与305名未接受激发试验的食物过敏个体的照料者进行比较。所有关于食物过敏个体反应特征的问卷数据均通过病历审查进行核实。
结果
共有115名接受口服食物激发试验的食物过敏个体的照料者完成了生活质量评估。接受口服食物激发试验的食物过敏个体的照料者的生活质量得分显著低于（更好）未接受激发试验的对照组（1.5对1.88；P = 0.02）。此外，在接受激发试验的队列中，口服食物激发试验通过者（例如，无反应）和未通过者（例如，有反应）之间的生活质量得分没有显著差异（1.42对1.34；P = 0.83）。在调整后的线性回归模型中，接受口服食物激发试验且收入>50,000美元的食物过敏个体的照料者的生活质量得分显著更好，但对于有多个食物过敏个体的照料者或食物过敏个体患有特应性皮炎的照料者，生活质量得分显著恶化。
结论
与未接受激发试验的对照组相比，接受口服食物激发试验的食物过敏个体的照料者的生活质量得分更好，但基于口服食物激发试验结果无显著差异。此外，生活质量还受收入、特应性皮炎的存在以及有多个食物过敏个体的影响。无论激发试验结果如何，口服食物激发试验都与照料者更好的生活质量相关。
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