背景:牛奶和鸡蛋过敏显著影响生活质量,特别是在儿童中。在这方面,食物口服免疫疗法(OIT)已成为一种有效的治疗选择;然而,频繁不良反应的发生构成了挑战,治疗期间需要密切监测。
目的:本研究旨在评估一种名为OITcontrol的新型移动/网络应用程序监控牛奶和鸡蛋OIT的能力。
方法:招募接受牛奶或鸡蛋OIT的患者,并将其分为2组:活动组使用OITcontrol应用程序并结合标准的书面监测方法,而对照组仅依赖书面日记。调查人员记录了医院的剂量,医院反应,并在网站上进行治疗。患者记录了他们每天的过敏原家庭剂量摄入量,家庭反应,并使用应用程序进行治疗。两组之间比较以下变量:医院的数量和严重程度以及报告的家庭反应,患者对OITcontrol应用程序或书面日记的粘附力,或在每日家庭剂量摄入量和家庭反应记录方面,和治疗和剂量调整依从性在家的情况下的反应。
结果:16名患者被分配使用OITcontrol应用程序以及其他书面方法进行监测(活动组),而14例患者仅依靠书面纸质日记(对照组)。在性别方面观察到类似的分布,年龄,基础特征,在OIT中治疗的过敏原,术前用药,和敏化概况。与对照组相比,活跃患者报告的医院和家庭反应数量相当。在记录系统使用方面,13/16(81%)活跃患者使用OIT控制应用程序,而10/14(71%)的对照患者依靠书面日记。在活跃的患者中,6/16(38%)使用了这两种方法,1名活跃患者仅使用书面方法。然而,对照组患者记录家庭反应的频率高于活跃患者(P=.009)。在活跃的患者中,该应用程序是记录反应的首选方法(59/86,69%),与书面日记(15/86,17%)或两种方法(12/86,14%;P<.001)相比。两组家庭记录反应的治疗依从性相似(P=0.15)。然而,仅在应用中记录的反应(36/59,61%)比在书面日记中记录的反应(29/71,41%)或在两个系统中记录的反应(4/12,33%)更频繁(P=.04).此外,在家庭记录的反应中出现中重度反应后,对剂量调整的依从性在活动组高于对照组(P<.001).仅在应用程序中记录的家庭反应(16/19,84%)更有可能遵循剂量调整(P<.001),而不是在书面日记中记录(3/20,15%)或使用两种方法(2/3,67%)。
结论:OITcontrol应用程序似乎是监测食物过敏儿童OIT治疗的有价值的工具。它被证明是记录每日家庭剂量摄入量和反应的合适方法,它似乎可以增强不良反应后对治疗适应症的依从性以及家庭反应中剂量调整的依从性。然而,需要进行更多的研究,以全面掌握在OIT管理中使用OITcontrol应用程序的好处和局限性。
BACKGROUND: Milk and egg allergies significantly impact the quality of life, particularly in children. In this regard, food oral immunotherapy (OIT) has emerged as an effective treatment option; however, the occurrence of frequent adverse reactions poses a challenge, necessitating close monitoring during treatment.
OBJECTIVE: This
study aims to evaluate the ability of a new mobile/web app called OITcontrol to monitor milk and egg OIT.
METHODS: Patients undergoing milk or egg OIT were recruited and divided into 2 groups: the active group used the OITcontrol app in conjunction with standard written monitoring methods, whereas the control group relied solely on written diaries. Investigators documented hospital doses, hospital reactions, and administered treatments on the website. Patients recorded their daily allergen home-dose intake, home reactions, and administered treatments using the app. The following variables were compared between both groups: number and severity of hospital and reported home reactions, patient\'s adhesion to the OITcontrol app or written diary or both in terms of daily home-dose intake and home reactions recording, and treatment and dose adjustment compliance at home in case of reaction.
RESULTS: Sixteen patients were assigned to be monitored using the OITcontrol app along with additional written methods (active group), while 14 patients relied solely on a written paper diary (control group). A similar distribution was observed in terms of sex, age, basal characteristics, allergen treated in OIT, premedication, and sensitization profile. Active patients reported a comparable number of hospital and home reactions compared with the control group. In terms of recording system usage, 13/16 (81%) active patients used the OITcontrol app, while 10/14 (71%) control patients relied on the written diary. Among active patients, 6/16 (38%) used both methods, and 1 active patient used only written methods. However, control patients recorded home reactions more frequently than active patients (P=.009). Among active patients, the app was the preferred method for recording reactions (59/86, 69%), compared with the written diary (15/86, 17%) or both methods (12/86, 14%; P<.001). Treatment compliance in home-recorded reactions was similar between both groups (P=.15). However, treatment indications after an adverse reaction were more frequently followed (P=.04) in reactions recorded solely in the app (36/59, 61%) than in the written diary (29/71, 41%) or both systems (4/12, 33%). Moreover, compliance with dose adjustments after a moderate-severe reaction in home-recorded reactions was higher in the active group than in the control group (P<.001). Home reactions recorded only in the app (16/19, 84%) were more likely to follow dose adjustments (P<.001) than those recorded in the written diary (3/20, 15%) or using both methods (2/3, 67%).
CONCLUSIONS: The OITcontrol app appears to be a valuable tool for monitoring OIT treatment in children with food allergies. It proves to be a suitable method for recording daily home dose intakes and reactions, and it seems to enhance adherence to treatment indications following an adverse reaction as well as compliance with dose adjustments in home reactions. However, additional studies are necessary to comprehensively grasp the benefits and limitations of using the OITcontrol app in the management of OIT.