Parent-Reported Food Allergy Quality of Care
Rationale: A strong relationship with care providers and high quality of care are essential to ensuring proper management of food allergy. The objective of this study was to evaluate the quality of care received by families of children with food allergy from both pediatricians and allergists.
Methods: 940 families of food-allergic children were included in a family-based cohort. Food allergy was determined by objective symptoms developing within 2 hours of ingestion, corroborated by skin prick test/specific IgE. Parents were asked questions about their satisfaction with and quality of care.
Bivariate analyses were used to describe parent reports of the quality of health services. A Mann-Whitney U test was used to compare perceived quality between mothers and fathers.
Results: Satisfaction with care and trust in physicians was high. Nearly all parents reported that pediatricians and allergists treated them with courtesy and respect, listened carefully, and treated their views with respect. Most parents also reported that their child’s physicians explained food allergies in a way they could understand and reported that they showed concern for the impact of food allergy on the family. Management steps in the NIAID guidelines were also assessed. Parents reported that 36% of pediatricians and 71% of allergists explained when to use an epinephrine auto-injector. Fewer pediatricians (17%) and allergists (46%) demonstrated how to use the device. A written food allergy action plan was provided by 20% of pediatricians and 56% of allergists. 23% of parents reported that pediatricians explained their child’s long term prognosis and 61% reported the same of allergists. Mothers largely reported more pessimistic perceptions of the quality of care they received while fathers generally recalled slightly higher perceptions of physician concern for impact and explanation of food allergy (p<0.05). Overall, there was strong within-family agreement on perception of healthcare quality.
Conclusion: Parents of children with food allergies feel cared for and respected by their child’s doctors. Ensuring proper management of food allergy by both pediatricians and allergists is critical. Increased education in healthcare settings around recognizing symptoms of an anaphylactic reaction and how and when to use an epinephrine auto-injector are needed. Food allergy action plans and counseling are also vital for all children with food allergy.