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Management of Children With Food-Induced Anaphylaxis: A Cross-Sectional Survey of Parental Knowledge, Attitude, and
Laura Polloni1,2, Ileana Baldi3, Margherita Amadi4
1Department of Women's and Children's Health, Food Allergy Referral Centre, Veneto Region, Padua University Hospital, Padua, Italy.
Insights
Parents of children with food allergies often hesitate to use auto-injectable adrenaline (AAI) due to fear, despite carrying it. Educational programs and psychological support are recommended to improve anaphylaxis management and AAI use.
Area of Science:
- Pediatric Allergy and Immunology
- Emergency Medicine
- Public Health
Background:
- Anaphylaxis is a severe allergic reaction that is frequently undertreated in children with food allergies.
- Auto-injectable adrenaline (AAI) is underutilized by patients and parents, increasing the risk of severe outcomes.
- Fatal anaphylaxis cases are often linked to delayed adrenaline administration.
Purpose of the Study:
- To investigate parental knowledge and practices regarding anaphylaxis management.
- To identify barriers and facilitators influencing the use of auto-injectable adrenaline (AAI) in pediatric food allergy.
- To inform the development of targeted educational interventions for parents.
Main Methods:
- A retrospective survey was conducted among 75 parents of children with food allergies prescribed AAI.
- Data collected included parental preparedness, AAI usage patterns, and perceived barriers/facilitators.
- Statistical analysis of survey responses to identify key trends.
Main Results:
- Most parents (77%) carried AAI, but only 20% reported using it during severe reactions.
- Primary barriers to AAI use were fear of making mistakes (46 parents) and concern over side effects (35 parents).
- Lack of knowledge regarding correct AAI use or symptom assessment was reported less frequently.
Conclusions:
- Parental preparedness for anaphylaxis management is suboptimal, with significant reluctance to use AAI.
- Addressing parental fears and providing practical training are crucial for improving AAI utilization.
- Multidisciplinary educational strategies, including theoretical-practical courses and psychological support, are recommended.
Background:
Anaphylaxis is a life-threatening event, but it is frequently undertreated in pediatric patients with food allergies. Previous studies showed that auto-injectable adrenaline (AAI) is underused by patients and parents. This is especially troubling since fatal anaphylaxis has been associated with delayed adrenaline administration.
Objectives:
This study aimed to investigate parental practice and knowledge in anaphylaxis management, and perceived barriers and facilitators in using AAI.
Results:
A retrospective survey was completed by 75 parents (41 mothers, 34 fathers) of children with food allergy and AAI prescription attending the Food Allergy Referral Center of Veneto, Italy. Results showed poor parental preparedness and reluctance to use AAI despite a high/moderate self-rated knowledge (median total score of 23-min. 3, max. 30). Most parents (77%) declared they were carrying AAI but only 20% used it in case of a severe reaction. Most reported Fear/Fear of making mistakes (46 parents) and Concern about possible side effects as barriers (35), while Poor knowledge of the correct AAI use (1) and Lack of knowledge/ incorrect assessment of symptoms (2) were reported less frequently. Theoretical-practical courses for parents on AAI use (65), Psycho-education/Psychological support (3) for better dealing with the emotional aspects of anaphylaxis and Written instructions (1) have been suggested as main facilitators.
Conclusion:
Understanding parents' experience and perspective on managing anaphylaxis is crucial to implement effective educational programs. A multidisciplinary approach should be considered.
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