McCann William A, Nowak-Wegrzyn Anna, Hass Steven L, Huang Danmeng, Donelson Sarah M
Allergy Partners P.A., Asheville, North Carolina, USA.
NYU Grossman School of Medicine, Hassenfeld Children's Hospital, New York, New York, USA.
Clin Transl Allergy. 2023 Mar;13(3):e12234. doi: 10.1002/clt2.12234.
Patients with peanut allergy (PA) experience significant burden of illness, which impacts health-related quality of life (HRQoL), particularly in adolescence. There is a paucity of research evaluating drivers of HRQoL scores.
A prospective, online survey of adolescents with self-reported, provider-diagnosed PA completed from November 2018 to January 2019 was used to explore drivers of the real-world impact of PA on HRQoL using the Pediatric Quality of Life Inventory 4.0 (PedsQL) and other measures. Univariate and multivariate analyses were used to identify potential factors associated with PedsQL scores and to understand the level of association.
A total of 102 adolescents were included. The final model included 10 variables: race, reported strict peanut avoidance, satisfaction with prophylaxis, moderate-to-severe reaction within the past 12 months, touching peanut as cause of most severe reaction, fear of reaction, age, gender, comorbidities, and daily life limitations. In total, three items were shown to be strong predictors of the PedsQL total score including cause of severe reaction was touching peanut (yes), level of agreement with avoiding peanut (completely agree), and satisfaction with prophylaxis (not very much/not at all).
There is substantial heterogeneity in the impact of the burden of PA on PedsQL scores across patients. This indicates the importance of shared and individualized decision making for PA management to optimize outcomes and improve HRQoL.
花生过敏（PA）患者承受着巨大的疾病负担，这会影响与健康相关的生活质量（HRQoL），尤其是在青少年时期。评估HRQoL评分驱动因素的研究较少。
2018年11月至2019年1月对自我报告、经医生诊断为PA的青少年进行了一项前瞻性在线调查，以使用儿童生活质量量表4.0（PedsQL）和其他指标探讨PA对HRQoL的现实世界影响的驱动因素。采用单因素和多因素分析来确定与PedsQL评分相关的潜在因素，并了解关联程度。
共纳入102名青少年。最终模型包括10个变量：种族、报告的严格避免食用花生情况、对预防措施的满意度、过去12个月内的中度至重度反应、接触花生作为最严重反应的原因、对反应的恐惧、年龄、性别、合并症和日常生活限制。总的来说，有三项被证明是PedsQL总分的强预测因素，包括严重反应的原因是接触花生（是）、对避免食用花生的认同程度（完全认同）以及对预防措施的满意度（不太满意/完全不满意）。
PA负担对不同患者PedsQL评分的影响存在很大异质性。这表明在PA管理中进行共同决策和个性化决策对于优化结果和改善HRQoL的重要性。
