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Communicating anaphylaxis risk in pediatric allergy consultations: A conversation analytic study
Laura Jenkins1, Jonathan Potter2, Alexa Hepburn2
1Department of Criminology, Sociology and Social Policy, Loughborough University, Loughborough, United Kingdom.
Patient Education and Counseling
|August 17, 2025
Summary
This study reveals how doctors communicate anaphylaxis risk and prescribe adrenaline auto-injectors to children. Clear communication strategies empower parents and patients in shared decision-making for allergy management.
Area of Science:
- Pediatric Allergy and Immunology
- Communication in Healthcare
- Risk Assessment and Management
Background:
- Childhood allergy prevalence is rising, with severe cases potentially leading to fatal anaphylaxis.
- Adrenaline auto-injectors are prescribed for at-risk children, but non-specialists often handle risk discussions.
- A need exists for systematic examination of risk communication strategies in pediatric allergy consultations.
Purpose of the Study:
- To identify strategies for communicating anaphylaxis risk to children and caregivers.
- To understand how adrenaline auto-injector prescribing decisions are negotiated in real pediatric allergy consultations.
Main Methods:
- Analysis of 23 video-recorded UK pediatric allergy consultations (children aged 2-10).
- Application of conversation analysis to 11 identified risk discussions.
- Focus on communication practices for anaphylaxis risk and auto-injector prescription decisions.
Main Results:
- Risk was communicated using categories (low, moderate, high), gestures, and discussion of reassuring/worrying factors.
- Uncertainty regarding medical evidence tempered risk assessments.
- Risk severity was carefully modified and tailored to individual interactions.
Conclusions:
- Expert knowledge on anaphylaxis risk was effectively shared, facilitating collaborative decision-making.
- Explicit reasoning about risk, without 'pushing' prescriptions, leveled the knowledge gap between doctors and families.
- Nuanced communication practices can inform educational tools for non-specialists in pediatric allergy care.
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