Awareness and Application of United States Food Allergy Prevention Guidelines Among Pediatricians and Other Clinicians - 08/11/24

Doi : 10.1016/j.jpeds.2024.114218

Julie Wang, MD ^1,^{^{∗
Co-first authors.}}, J. Andrew Bird, MD ^2,^{^{∗
Co-first authors.}}, Kelly Cleary, MD ³, Julianne Doucette, DNP, APRN, CPNP-PC ⁴, George du Toit, MD ⁵, Marion Groetch, MS, RD ^1,⁶, Ruchi Gupta, MD, MPH ⁷, Kathleen H. Hathaway, MA, BSN ⁸, Sara Klein, MBA ³, Gideon Lack, MD ⁵, Stephanie Leeds, MD, MHS ⁹, Tiffany Leon, MS, RD ³, Megan O. Lewis, MSN, RN, CPNP-PC ¹⁰, Jay Lieberman, MD ¹¹, Anna Nowak-Wegrzyn, MD, PhD ^12,¹³, Paul Scribner, MSW ³, Brian P. Vickery, MD ¹⁴, Christopher M. Warren, PhD ^7,^⁎
¹ Elliot and Roslyn Jaffe Food Allergy Institute, Division of Allergy and Immunology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY
² Department of Pediatrics, Division of Allergy and Immunology, UT Southwestern Medical Center, Dallas, TX
³ Food Allergy Research & Education (FARE), McLean, VA
⁴ Primary Care Pediatric Nurse Practitioner DNP Program, Rush University, Chicago, IL
⁵ Pediatric Allergy, King's College London, London, UK
⁶ Division of Pediatric Allergy & Immunology, Icahn School of Medicine at Mount Sinai, New York, NY
⁷ Center for Food Allergy and Asthma Research, Institute for Public Health and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
⁸ Joe DiMaggio Children's Hospital, Memorial Healthcare System, Hollywood, FL
⁹ Division of Pediatric Allergy and Immunology, Yale School of Medicine, New Haven, CT
¹⁰ Food Allergy Center, Children's Hospital of Philadelphia, Philadelphia, PA
¹¹ Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN
¹² Hassenfeld Children's Hospital, Department of Pediatrics, NYU Grossman School of Medicine, New York, NY
¹³ Gastroenterology and Nutrition, Collegium Medicum, University of Warmia and Mazury, Olsztyn, Poland
¹⁴ Emory University and Children's Healthcare of Atlanta, Atlanta, GA

^∗Reprint requests: Christopher M. Warren, PhD, North Lake Shore Drive, 6th floor suite 633, Chicago, IL 60611.North Lake Shore Drive6th floor suite 633ChicagoIL60611

Abstract

Objective

To characterize the awareness of, adherence to, and barriers to the 2017 National Institute of Allergy and Infectious Diseases (NIAID) peanut allergy prevention guidelines among the pediatrics health care workforce.

Study design

Pediatricians, family physicians, advanced practice providers (APPs), and dermatologists who provide care for infants were solicited for a population-based online survey, administered from June 6, 2022, through July 3, 2022. The survey collected information about NIAID guideline awareness, implementation, and barriers as well as concerns related to the guidelines.

Results

A total of 250 pediatricians, 250 family physicians, 504 APPs, and 253 dermatologists met inclusion criteria. Self-reported guideline awareness was significantly higher for pediatricians (76%) compared with dermatologists (58%), family physicians (52%), and APPs (45%) (P < .05). Among participants who were aware of the guidelines, most reported using part or all of the guidelines in their clinical practices. Reported practice patterns for peanut introduction in 6-month-old infants were variable and did not always align with guidelines, particularly for infants with mild-to-moderate atopic dermatitis.

Conclusions

Although pediatricians have the highest self-reported level of NIAID guideline awareness, awareness was suboptimal irrespective of provider type. Education for all pediatric clinicians is urgently needed to promote evidence-based peanut allergy prevention practices.

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Keywords : allergy prevention, Allied Health, food allergy prevention, guideline implementation

Abbreviations : AAP, AD, APPs, CI, FA, FARE, HCP, LEAP, NIAID, NP, PCP, PPA, RCT, sIgE

Plan

Methods

Survey Development and Structure

Study Design and Participants

Awareness and Implementation

Barriers to Implementation and Educational Needs

Discussion

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Vol 275

Article 114218- décembre 2024 Retour au numéro

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Awareness and Application of United States Food Allergy Prevention Guidelines Among Pediatricians and Other Clinicians - 08/11/24

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