Brazilian pediatricians' adherence to food allergy guidelines-A cross-sectional study

PLoS One. 2020 Feb 24;15(2):e0229356. doi: 10.1371/journal.pone.0229356. eCollection 2020.

Abstract

Food allergy is an emerging clinical condition in pediatrics, so recommendations on its management have been widely published. Studying pediatricians' adherence to these clinical practice guidelines (CPG) and understanding the reasons for their non-compliance can help to promote better management of this condition. A cross-sectional study was conducted by a survey among Brazilian pediatricians, randomly selected during the 38th Brazilian Congress of Pediatrics, which took place in October, 2017. A validated questionnaire with 16 questions addressing knowledge and practice on food allergy, as well as self-reported adherence to international guidelines was applied. Of the total of 415 pediatricians from all regions of the country who were surveyed, only 69 (16.7%) had a satisfactory adherence rate (≥80%). Adequate adherence to the guidelines was associated with the variables: 'evaluating more than 10 children with suspected cow's milk allergy (CMA) per month'; 'having read the Brazilian consensus'; or 'being aware of any international food allergy guideline'. In 8 of the 10 questions that assessed conscious adherence, a minority of those surveyed (20.3-42.3% variation) stated that they knew that their response was in line with the guidelines. This finding was statistically significant (p<0.05) in 7 of these 8 questions. The self-reported adherence of Brazilian pediatricians to international food allergy guidelines was low. Pediatricians who evaluated a higher number of children with suspected CMA or who were aware of the recommendations, had a higher rate of adherence. The results of the survey found that lack of resource was the major reported barrier to guideline adherence but lack of awareness must be a relevant non perceived barrier. This study shows the pediatricians´ self-reported adherence to food allergy guidelines in a widely overview for the first time in Brazil. More studies are necessary to investigate adherence to guidelines by pediatricians in other countries and to develop strategies to improve adherence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Awareness
  • Brazil / epidemiology
  • Cross-Sectional Studies
  • Female
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / therapy*
  • Guideline Adherence / statistics & numerical data*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Middle Aged
  • Milk Hypersensitivity / epidemiology
  • Milk Hypersensitivity / therapy
  • Pediatricians / standards
  • Pediatricians / statistics & numerical data*
  • Practice Patterns, Physicians' / standards
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surveys and Questionnaires

Grants and funding

This publication was partly funded by CAPES (PROAP budget) from Graduate Program in Health Sciences-Federal University of Sergipe (UFS), Brazil. We also declare that our study received no funding from any company or institution for the field work and development, all costs for this were due to the authors. Publication fee was in part supported by Federal University of Sergipe institutional funds (PROAP) received from CAPES - Graduate Studies Coordination, a Brazilian Government Institution – award number 23113.063993/2019-77. All methods decisions, paper preparation and decision to publish were taken by the authors, with no interference from funders.