Awareness and Application of United States Food Allergy Prevention Guidelines Among Pediatricians and Other Clinicians
Year: 2025
Type: conference-abstract
Abstract: The National Institute of Allergy and Infectious Disease (NIAID) released Prevention of Peanut Allergy guidelines in 2017. These were drafted following studies that highlighted the importance of early introduction of peanuts in infants, especially those with egg allergy and eczema. This early introduction is safe and efficacious in preventing food allergy. This study assesses the awareness of and adherence to these guidelines by clinicians who provide care for children.A third-party market research company (Dynata, Plano) identified a diverse and representative sample of online panel members including pediatricians, pediatric family physicians, advanced practice providers (APPs), and dermatologists. The study population included a total of 46 201 people who received the survey and 3849 who answered the first question, with a response rate of 8.3%. The final survey analysis included 250 pediatricians, 250 family physicians, 253 nurse practitioners, 251 physician assistants, and 253 dermatologists.The company administered the survey to panel members from June 6 through July 3, 2022. The survey included 45 items to assess for eligibility, demographic/practice information, and food allergy prevention.The primary outcome assessed participant awareness of the guidelines for peanut introduction and implementation of them. The study noted self-reported guideline awareness in 76% of the pediatricians, whereas self-reported guideline awareness was lower in nonpediatric clinicians including 58% of dermatologists, 52% of family physicians, and 45% for APPs. Of those who noted awareness, only 26% of pediatricians and 30% of dermatologists reported they followed the guidelines closely. Furthermore, within those that followed any guidelines, between 53% and 57% of the pediatricians recommended early introduction in mild to moderate atopic dermatitis, whereas 18% to 38% of nonpediatricians would recommend it. If they did not recommend the early introduction, they would refer to an allergist, order peanut-specific allergen testing, or recommend avoidance of peanuts. Barriers to implementation included lack of clinic time, parental concerns, or clinician concerns.The study noted that despite awareness of these guidelines in pediatricians and other clinicians, the reported implementation and adherence was low. Furthermore, the implementation and adherence was lower in nonpediatric clinicians including dermatologists and APPs. This suggests the need for improvement in continuing education for these clinicians.The NIAID Prevention of Peanut Allergy guidelines have been available since 2017. Despite the widespread knowledge in pediatricians, there is a significant gap in clear implementation of these guidelines in this population, especially in patients with mild to moderate eczema. This leads to missed opportunities for peanut introduction in patients who are at risk. We need to work further on minimizing barriers to this implementation, which can start with education from allergy specialists. Furthermore, as the pediatrician workforce shifts to more well-child visits completed by family medicine providers and APPS, it is essential we help educate these clinicians on these new guidelines and improve implementation. This education can help address food allergies on a population scale and is essential to the treatment/prevention of food allergies.
Source: PEDIATRICS
Author: Jennifer M. Miller
Language: English
Subfield: Immunology and Allergy
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W4416832410
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