Versluis Astrid, Le Thuy-My, Erp Francine C van, Blankestijn Mark A, Houben Geert F, Knulst André C, Os-Medendorp Harmieke van
Department of Dermatology/Allergology, University Medical Centre Utrecht, University Utrecht, Utrecht, The Netherlands.
TNO, Netherlands Organization for Applied Scientific Research, Utrecht, The Netherlands.
Clin Transl Allergy. 2022 Feb;12(2):e12119. doi: 10.1002/clt2.12119.
After a positive food challenge (FC), patients receive dietary advice regarding avoidance of the culprit food. We examined the frequency and variables associated with dietary adherence after a positive FC in adults.
In this prospective daily practice study, adults with a positive FC were included. After every FC, dietary advice was given consisting of three options: (1) strict avoidance, (2) avoidance but products with precautionary allergen labelling (PAL) allowed and (3) (small) amounts allowed. Questionnaires about dietary adherence and associated variables were completed prior to and 6 months after the FC(s).
41 patients (with 58 positive FCs) were included. Overall, patients adhered to the advised diet after 31% of the FCs. After 33 FCs, the advice was strict avoidance, whereof 82% followed a less strict diet. After 16 FCs, the advice was avoidance but products with PAL allowed, whereof 19% followed a less strict and 25% a stricter diet. In 9 FCs with the least strict advice, "(small) amounts allowed'', 67% followed a stricter diet. Three variables were associated with adherence: misremembering dietary advice, impaired health-related quality of life (HRQL) on domain "Emotional impact'' and the need for dietary change after the FC.
After one third of the positive FCs, patients adhered to the dietary advice. Variables associated with adherence were misremembering dietary advice, impaired HRQL on domain "Emotional impact'' and the need for dietary change after the FC. It seems important that healthcare professionals should more frequently apply adherence-enhancing strategies to improve dietary adherence.
在食物激发试验（FC）呈阳性后，患者会收到关于避免食用致病食物的饮食建议。我们研究了成人食物激发试验呈阳性后饮食依从性的频率及相关变量。
在这项前瞻性日常实践研究中，纳入了食物激发试验呈阳性的成年人。每次食物激发试验后，都会给出三种饮食建议：（1）严格避免；（2）避免，但允许食用带有预防性过敏原标签（PAL）的产品；（3）允许（少量）食用。在食物激发试验之前和之后6个月，完成关于饮食依从性及相关变量的问卷调查。
纳入了41例患者（共58次阳性食物激发试验）。总体而言，患者在31%的食物激发试验后遵守了建议饮食。33次食物激发试验的建议是严格避免，其中82%的患者遵循了不太严格的饮食。16次食物激发试验的建议是避免，但允许食用带有PAL的产品，其中19%的患者遵循了不太严格的饮食，25%的患者遵循了更严格的饮食。在9次给出最宽松建议“允许（少量）食用”的食物激发试验中，67%的患者遵循了更严格的饮食。有三个变量与依从性相关：记错饮食建议、“情绪影响”领域的健康相关生活质量（HRQL）受损以及食物激发试验后对饮食改变的需求。
在三分之一的阳性食物激发试验后，患者遵守了饮食建议。与依从性相关的变量是记错饮食建议、“情绪影响”领域的HRQL受损以及食物激发试验后对饮食改变的需求。医疗保健专业人员应更频繁地应用增强依从性的策略来提高饮食依从性，这似乎很重要。
