Division of Allergy and Clinical Immunology, Department of Internal Medicine, The University of Michigan Medical School, University of Michigan Health System, Ann Arbor, Michigan.
Division of Allergy and Clinical Immunology, Department of Internal Medicine, The University of Michigan Medical School, University of Michigan Health System, Ann Arbor, Michigan; The University of Michigan Food Allergy Center, Ann Arbor, Michigan; The Child Health Evaluation and Research Unit, Department of Pediatrics, The University of Michigan Medical School, Ann Arbor, Michigan.
Ann Allergy Asthma Immunol. 2015 Apr;114(4):312-318.e2. doi: 10.1016/j.anai.2014.12.022. Epub 2015 Feb 7.
Caregivers of food-allergic individuals (FAIs) have decreased quality of life (QoL). The effects of epinephrine administration on QoL are poorly understood.
To investigate the relation between QoL and epinephrine use.
A de-identified 50-question online survey was administered to caregivers of FAIs across the United States through Web site, email, and social media networks of 2 national food allergy advocacy groups. QoL was assessed using the Food Allergy Quality of Life-Parental Burden questionnaire. The effect of prior epinephrine administration on QoL was analyzed using linear regression.
Of 3,541 respondents, 35.6% reported their FAIs received epinephrine. Mean Food Allergy Quality of Life-Parental Burden scores were higher (worse QoL) in those reporting FAIs receiving epinephrine (3.07 vs 2.84, P < .001), anaphylaxis (3.01 vs 2.75, P < .001), multiple food allergies (3.16 vs 2.67, P < .001), and multiple food allergies and epinephrine use (3.24 vs 2.57, P < .001) vs those who did not. In a regression model, reported epinephrine use; anaphylaxis; multiple FAIs; multiple food allergies; and egg or milk, wheat or soy, or seafood allergy (vs peanut or tree nut allergy) were significantly associated with an increased (worse) QoL score. Caregiver college education and increasing FAI age were associated with a decreased QoL score (improved QoL). An interaction was noted between reported epinephrine use and anaphylaxis and was associated with a decreased QoL score.
The effect of epinephrine use on caregiver QoL is conditional and depends on reaction severity. Having multiple FAIs and FAIs with multiple food allergies was associated with worsening QoL. Further studies are needed to better understand the effects of treating an allergic reaction on caregiver QoL.
食物过敏个体（FAI）的照料者生活质量（QoL）下降。肾上腺素给药对 QoL 的影响知之甚少。
研究 QoL 与肾上腺素使用之间的关系。
通过 2 个国家食物过敏倡导组织的网站、电子邮件和社交媒体网络，向美国各地的 FAI 照料者发放了一份 50 个问题的匿名在线调查。使用食物过敏生活质量-父母负担问卷评估 QoL。使用线性回归分析先前肾上腺素给药对 QoL 的影响。
在 3541 名应答者中，35.6%报告其 FAI 接受了肾上腺素。报告 FAI 接受肾上腺素（3.07 比 2.84，P <.001）、过敏反应（3.01 比 2.75，P <.001）、多种食物过敏（3.16 比 2.67，P <.001）和多种食物过敏和肾上腺素使用（3.24 比 2.57，P <.001）的父母，其食物过敏生活质量-父母负担评分较高（QoL 较差）。在回归模型中，报告的肾上腺素使用；过敏反应；多种 FAI；多种食物过敏；以及鸡蛋或牛奶、小麦或大豆或海鲜过敏（而非花生或坚果过敏）与 QoL 评分增加（恶化）显著相关。照料者的大学教育程度和 FAI 年龄的增加与 QoL 评分降低（改善）相关。注意到报告的肾上腺素使用和过敏反应之间存在交互作用，与 QoL 评分降低相关。
肾上腺素使用对照料者 QoL 的影响是有条件的，取决于反应严重程度。有多种 FAI 和多种食物过敏的 FAI 与 QoL 恶化相关。需要进一步研究以更好地了解治疗过敏反应对照料者 QoL 的影响。
