Management of Children With Food-Induced Anaphylaxis: A Cross-Sectional Survey of Parental Knowledge, Attitude, and Practices

Laura Polloni; Ileana Baldi; Margherita Amadi; Valentina Tonazzo; Roberta Bonaguro; Francesca Lazzarotto; Alice Toniolo; Dario Gregori; Antonella Muraro

doi:10.3389/fped.2022.886551

Management of Children With Food-Induced Anaphylaxis: A Cross-Sectional Survey of Parental Knowledge, Attitude, and Practices

Front Pediatr. 2022 May 19:10:886551. doi: 10.3389/fped.2022.886551. eCollection 2022.

Authors

Laura Polloni^{1

2}, Ileana Baldi³, Margherita Amadi⁴, Valentina Tonazzo⁴, Roberta Bonaguro¹, Francesca Lazzarotto¹, Alice Toniolo¹, Dario Gregori³, Antonella Muraro¹

Affiliations

¹ Department of Women's and Children's Health, Food Allergy Referral Centre, Veneto Region, Padua University Hospital, Padua, Italy.
² Unit of Psychology, Padua University Hospital, Padua, Italy.
³ Unit of Biostatistics, Epidemiology and Public Health, Department of Cardiac, Thoracic and Vascular Sciences and Public Health, University of Padua, Padua, Italy.
⁴ Department of Women's and Children's Health, School of Medicine and Surgery, University of Padua, Padua, Italy.

Abstract

Background: Anaphylaxis is a life-threatening event, but it is frequently undertreated in pediatric patients with food allergies. Previous studies showed that auto-injectable adrenaline (AAI) is underused by patients and parents. This is especially troubling since fatal anaphylaxis has been associated with delayed adrenaline administration.

Objectives: This study aimed to investigate parental practice and knowledge in anaphylaxis management, and perceived barriers and facilitators in using AAI.

Results: A retrospective survey was completed by 75 parents (41 mothers, 34 fathers) of children with food allergy and AAI prescription attending the Food Allergy Referral Center of Veneto, Italy. Results showed poor parental preparedness and reluctance to use AAI despite a high/moderate self-rated knowledge (median total score of 23-min. 3, max. 30). Most parents (77%) declared they were carrying AAI but only 20% used it in case of a severe reaction. Most reported Fear/Fear of making mistakes (46 parents) and Concern about possible side effects as barriers (35), while Poor knowledge of the correct AAI use (1) and Lack of knowledge/ incorrect assessment of symptoms (2) were reported less frequently. Theoretical-practical courses for parents on AAI use (65), Psycho-education/Psychological support (3) for better dealing with the emotional aspects of anaphylaxis and Written instructions (1) have been suggested as main facilitators.

Conclusion: Understanding parents' experience and perspective on managing anaphylaxis is crucial to implement effective educational programs. A multidisciplinary approach should be considered.

Keywords: adrenaline; anaphylaxis; autoinjector; children; education; food allergy; management; parents.