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Twenty four‐hour helpline access to expert management advice for food‐allergy‐triggered anaphylaxis in infants, children and young people: a pragmatic, randomized controlled trial
Author(s) -
Kelleher M. M.,
DunnGalvin A.,
Sheikh A.,
Cullinane C.,
Fitzsimons J.,
Hourihane J. O'B.
Publication year - 2013
Publication title -
allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.363
H-Index - 173
eISSN - 1398-9995
pISSN - 0105-4538
DOI - 10.1111/all.12310
Subject(s) - medicine , randomized controlled trial , quality of life (healthcare) , food allergy , allergy , pediatrics , physical therapy , intervention (counseling) , anaphylaxis , nursing , immunology
Background Anaphylaxis is a life‐threatening emergency. If promptly administered, adrenaline is potentially life‐saving. Many food‐allergic‐children/carers are unsure when to use their adrenaline autoinjectors, contributing to a low quality of life and worse outcomes in the setting of an acute allergic reaction. Objectives The aim of this study was to assess the effectiveness of 24‐hour telephone access to specialist clinical advice on disease‐specific quality of life. Methods A pragmatic two‐arm, parallel‐group randomized control trial was conducted. Children/carers (<16 years) with food allergy, trained in adrenaline auto‐injector use, were recruited from a hospital‐based paediatric allergy clinic. Baseline disease‐specific quality of life was ascertained using the validated Food‐Allergy‐Related Quality‐of‐Life Questionnaire ( FAQLQ ), either Parent Form, Child Form or Teenager Form depending on child's age. Participants were then centrally randomized for a 6‐month period to 24‐hour telephone specialist support line or to usual care. The primary outcome measure was a change in FAQL scores, at one and 6 months postrandomization, compared with baseline. The minimum clinically important difference ( MCID ) in score is 0.5. Results Fifty two children/carers were recruited. FAQL scores remained static in the control group across the three time points. Scores gradually improved in the intervention group, with a significant difference seen at 6 months (T1–T3 Mean difference = −1.5, ( CI 0.87–2.25) P < 0.005] Follow‐up questionnaires, 6 months after the intervention was removed, T4, showed sustained significant difference between the groups (control M = 3.0; intervention M = 1.1[ t = −4.113, P < 0.05]). Conclusion The 24‐hour helpline improved food‐allergy‐specific quality of life in children. Six‐month intervention support resulted in sustained benefits for at least a further 6 months.