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The RCPCH care pathway for children with venom allergies: an evidence and consensus based national approach
Nicola Brathwaite1, George du Toit, Kate Lloydhope
1Department of Child Health, Kings College Hospital NHS Foundation Trust, Denmark Hill, London SE5 9RS, UK. nicola.brathwaite@nhs.net
Insights
This study outlines a national care pathway for pediatric venom allergies, emphasizing safe and effective venom immunotherapy for bee and wasp allergies. It guides service development to improve children's quality of life and access to care.
Area of Science:
- Pediatric Allergy and Immunology
- Clinical Pathway Development
- Public Health Initiatives
Background:
- National care pathways are crucial for standardizing pediatric allergy treatment.
- The Royal College of Paediatrics and Child Health (RCPCH) developed a venom allergy pathway to enhance equity in care for children with allergic conditions.
- This initiative addresses the need for defined competences in managing pediatric allergies.
Framework:
- The venom allergy pathway is built upon a comprehensive evidence review.
- It details ideal care from self-management to follow-up, including defined entry points.
- Key findings support venom immunotherapy's safety and efficacy for bee and wasp allergies, alongside quality of life improvements.
Implementation:
- Developed by a multidisciplinary team, the pathway underwent extensive stakeholder review, including public input.
- The pathway provides a guide for training and service development.
- It emphasizes creating networks between primary, secondary, and tertiary care settings.
Implications:
- Implementation of this pathway can improve the delivery of pediatric allergy care, bringing services closer to patients.
- Measuring serum tryptase post-reaction is highlighted as valuable.
- The pathway aims to enhance the overall quality of care for children with allergic conditions through integrated multidisciplinary teams.
Aims:
The Royal College of Paediatrics and Child Health (RCPCH) Science & Research Department was commissioned by the Department of Health to develop national care pathways for children with allergies; the venom allergy pathway is the seventh pathway. The pathways focus on defining the competences to improve the equity of care received by children with allergic conditions.
Method:
The RCPCH venom allergy pathway was developed by a multidisciplinary working group and was based on a comprehensive review of evidence. The pathway was reviewed by a broad group of stakeholders including the public and approved by the Allergy Care Pathways Project Board and the RCPCH Clinical Standards Committee.
Results:
The pathway results are presented in four parts: evidence review, mapping, external review and core knowledge documents. The entry points are defined and the ideal pathway of care is described from self-care through to follow-up. The evidence highlighted that venom immunotherapy is safe and effective for bee and wasp allergy and that there are real quality of life benefits for patients. The review also highlighted the value of measuring serum tryptase after reactions.
Conclusions:
The venom allergy pathway provides a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible. The authors recommend that this pathway should be implemented locally by a multidisciplinary team with a focus on creating networks between primary, secondary and tertiary care to improve services for children with allergic conditions.
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