2017年,发布了《预防花生过敏附录指南》,并建议根据婴儿的临床病史早期引入含花生的食物。
我们试图在美国进行一项全国性调查,以评估管理婴儿食物过敏的变态反应学家和免疫学家的指南实施情况。
调查邀请已送达3281名非退休人员,美国哮喘学会的美国成员,过敏和免疫学,董事会认证的过敏和免疫学。调查评估了对《准则》的认识和执行情况以及执行障碍。生成描述性统计数据。
29%(3281人中的946人)接受调查的变态反应学家/免疫学家做出了回应,87.1%(946人中的825人)的应答者符合资格标准。在合格的响应者中,97.1%的人了解该指南。其中,64.5%的人报告说,已公布的准则得到了全面执行,34.4%报告部分实施,1.1%的人报告没有使用任何指南。使用指南的障碍包括父母(47.6%)和自我(21.8%)对过敏反应的担忧,缺乏转介(33.6%),父母对早期喂养不感兴趣(28.2%),和缺乏临床时间(20.9%)。与指南最常见的两个偏差是考虑指南中未指定的其他因素,例如家族史(50.2%)和对非高危儿童进行皮肤点刺测试(43.9%)。在使用准则的受访者中,45.7%的人表示他们需要更多的教育或培训。基本上所有对调查做出回应的变态反应学家/免疫学家都报告了全部或部分指南的实施。父母的担忧和缺乏转介是主要的可识别障碍。有必要向父母和转诊医生传达改进的指南信息。
In 2017, the Addendum
Guidelines for the Prevention of Peanut Allergy were published with recommendations on early introduction of peanut-containing foods based on infants\' clinical history.
We sought to conduct a nationwide US survey to assess Guidelines implementation among allergists and immunologists who manage infants for food allergy.
Survey invitations were delivered to 3281 nonretired, US members of the American Academy of Asthma, Allergy & Immunology, board certified in allergy and immunology. The survey assessed awareness and implementation of the Guidelines and barriers to implementation. Descriptive statistics were generated.
Twenty-nine percent (946 of 3281) of surveyed allergists/immunologists responded, and 87.1% (825 of 946) of responders met eligibility criteria. Among eligible responders, 97.1% were aware of the
Guidelines. Of these, 64.5% reported full implementation of the Guidelines as published, 34.4% reported partial implementation, and 1.1% reported using none of the
Guidelines. Barriers to Guidelines use included parental (47.6%) and self (21.8%) concerns about allergic reactions, lack of referrals (33.6%), parents uninterested in early feeding (28.2%), and lack of clinic time (20.9%). The 2 most common deviations from the Guidelines were considering additional factors not specified in the Guidelines such as family history (50.2%) and conducting skin prick testing in non-high-risk children (43.9%). Of respondents using the
Guidelines, 45.7% indicated they needed more education or training.
Essentially all allergists/immunologists who responded to the survey reported full or partial Guidelines implementation. Parental concerns and lack of referrals are major identifiable barriers. Improved
Guidelines messaging to parents and referring physicians is warranted.