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Allergo Journal International

, Volume 23, Issue 7, pp 252–260 | Cite as

Quality of life in the setting of anaphylaxis and food allergy

  • Lars Lange
Review

Abstract

The diagnosis of a food allergy generally has a considerable impact on patients. Not does it result in dietary restrictions, it is often also associated with a constant threat scenario, given the risk of sudden allergic reactions, including life-threatening anaphylaxis. It is essential for patients to receive training on how to deal with emergency situations and make the correct decision regarding the use of emergency medication. Severe allergic reactions occur only rarely if patients are well informed. However, the fear of allergic reactions results in a significant impairment in quality of life (QoL).

In recent years, numerous studies have been carried out on QoL in food-allergy and anaphylaxis patients. These studies provide insight into patient behaviour in everyday life. More importantly, by means of targeted and specific counselling, they also make it possible to reduce adverse effects on QoL and improve avoidance behaviour and compliance in terms of the requisite emergency measures.

The present article summarizes the available data and formulates recommendations aimed at improving the care of food-allergy patients in terms of QoL and compliance.

Key words

Food allergy anaphylaxis quality of life children adolescents adults 

Abbreviations

AAI

Adrenaline autoinjector

AGATE

Arbeitsgemeinschaft Anaphylaxie Training und Edukation e.V.

FAQLQ

Food allergy quality of life questionnaire

FAQLQ-AF

Food allergy quality of life questionnaire adult form

HRQoL

Health-related quality of life

IgE

Immunglobulin E

QoL

Quality of life

Notes

Acknowledgement

My thanks go to Prof. Dr. Uwe Gieler for his critical review of the manuscript.

Literatur

  1. 1.
    Umasunthar T, Leonardi-Bee J, Hodes M, Turner PJ, Gore C, Habibi P et al. Incidence of fatal food anaphylaxis in people with food allergy: a systematic review and meta-analysis. Clin Exp Allergy 2013;43:1333–41PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Beyer K, Eckermann O, Hompes S, Grabenhenrich L, Worm M. Anaphylaxis in an emergency setting - elicitors, therapy and incidence of severe allergic reactions. Allergy 2012;67:1451–6PubMedCrossRefGoogle Scholar
  3. 3.
    Grabenhenrich L, Hompes S, Gough H, Ruëff F, Scherer K, Pföhler C et al. Implementation of anaphylaxis management guidelines: a register-based study. PLoS One 2012;7:e35778PubMedCentralPubMedCrossRefGoogle Scholar
  4. 4.
    Flokstra-de Blok BM, Dubois AE. Quality of life measures for food allergy. Clin Exp Allergy 2012;42:1014–20PubMedCrossRefGoogle Scholar
  5. 5.
    Flokstra-de Blok BM, Dubois AE. Quality of life in food allergy: valid scales for children and adults. Curr Opin Allergy Clin Immunol 2009;9:214–21PubMedCrossRefGoogle Scholar
  6. 6.
    Flokstra-de Blok BMJ, Dubois AEJ, Vlieg-Boerstra BJ, Oude Elberink JNG, Raat H, DunnGalvin A et al. Health related quality of life of food allergic patients: comparison with the general population and other diseases. Allergy 2010;65:238–44PubMedCrossRefGoogle Scholar
  7. 7.
    Flokstra-de Blok BM, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ, Hourihane JO et al. Development and validation of a self-administered Food Allergy Quality of Life Questionnaire for children. Clin Exp Allergy 2009;39:127–37PubMedCrossRefGoogle Scholar
  8. 8.
    Flokstra-de Blok BM, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ, Hourihane JO et al. Development and validation of the self-administered Food Allergy Qualityof Life Questionnaire for adolescents. J Allergy Clin Immunol 2008;122:139–44PubMedCrossRefGoogle Scholar
  9. 9.
    Flokstra-de Blok BM, Meulen GN van der, DunnGalvin A, Vlieg-Boerstra BJ, Oude Elberink JN, Duiverman EJ et al. Development and validation of the Food Allergy Quality of Life Questionnaire - adult form. Allergy 2009;64:1209–17PubMedCrossRefGoogle Scholar
  10. 10.
    DunnGalvin A, Flokstra de Blok BM, Burks AW, Dubois AE, Hourihane JO. Food allergy QoL questionnaire for children aged 0-12 years: content, construct, and cross-cultural validity. Clin Exp Allergy 2008;38:977–86PubMedCrossRefGoogle Scholar
  11. 11.
    Velde JL van der, Flokstra-de Blok BM, Vlieg-Boerstra BJ, Oude Elberink JN, Schouten JP, Dunngalvin A et al. Testretest reliability of the Food Allergy Quality of Life Questionnaires (FAQLQ) for children, adolescents and adults. Qual Life Res 2009;18:245–51PubMedCrossRefGoogle Scholar
  12. 12.
    Avery NJ, King RM, Knight S, Hourihane JO. Assessment of quality of life in children with peanut allergy. Pediatr Allergy Immunol 2003;14:378–82PubMedCrossRefGoogle Scholar
  13. 13.
    Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy 2010;65:933–45PubMedCrossRefGoogle Scholar
  14. 14.
    King RM, Knibb RC, Hourihane JO. Impact of peanut allergy on quality of life, stress and anxiety in the family. Allergy 2009;64:461–8PubMedCrossRefGoogle Scholar
  15. 15.
    Lyons AC, Forde EM. Food allergy in young adults: perceptions and psychological effects. J Health Psychol 2004;9:497–504PubMedCrossRefGoogle Scholar
  16. 16.
    Sicherer SH, Noone SA, Munoz-Furlong A. The impact of childhood food allergy on quality of life. Ann Allergy Asthma Immunol 2001;87:461–4PubMedCrossRefGoogle Scholar
  17. 17.
    Marklund B, Ahlstedt S, Nordstrom G. Health-related quality of life in food hypersensitive schoolchildren and their families: parents’ perceptions. Health Qual Life Outcomes 2006;4:48PubMedCentralPubMedCrossRefGoogle Scholar
  18. 18.
    Marklund B, Ahlstedt S, Nordstrom G. Health-related quality of life among adolescents with allergy-like conditions - with emphasis on food hypersensitivity. Health Qual Life Outcomes 2004;2:65PubMedCentralPubMedCrossRefGoogle Scholar
  19. 19.
    Wassenberg J, Cochard MM, Dunngalvin A, Ballabeni P, Flokstra-de Blok BM, Newman CJ et al. Parent perceived quality of life is age-dependent in children with food allergy. Pediatr Allergy Immunol 2012;23:412–9PubMedCrossRefGoogle Scholar
  20. 20.
    Bollinger ME, Dahlquist LM, Mudd K, Sonntag C, Dillinger L, McKenna K. The impact of food allergy on the daily activities of children and their families. Ann Allergy Asthma Immunol 2006;96:415–21PubMedCrossRefGoogle Scholar
  21. 21.
    Gillespie CA, Woodgate RL, Chalmers KI, Watson WT. „Living with risk’’: mothering a child with food-induced anaphylaxis. J Pediatr Nurs 2007;22:30–42PubMedCrossRefGoogle Scholar
  22. 22.
    Calsbeek H, Rijken M, Dekker J, Berge Henegouwen GP van. Disease characteristics as determinants of the labour market position of adolescents and young adults with chronic digestive disorders. Eur J Gastroenterol Hepatol 2006;18:203–9PubMedCrossRefGoogle Scholar
  23. 23.
    Munoz-Furlong A. Daily coping strategies for patients and their families. Pediatrics 2003;111:1654–61PubMedGoogle Scholar
  24. 24.
    Shemesh E, Annunziato RA, Ambrose MA, Ravid NL, Mullarkey C, Rubes M, Chuang K, Sicherer M, Sicherer SH. Child and parental reports of bullying in a consecutive sample of children with food allergy. Pediatrics 2013;131:e10–7PubMedCentralPubMedCrossRefGoogle Scholar
  25. 25.
    Primeau MN, Kagan R, Joseph L, Lim H, Dufresne C, Duffy C et al. The psychological burden of peanut allergy as perceived by adults with peanut allergy and the parents of peanut-allergic children. Clin Exp Allergy 2000;30:1135–43PubMedCrossRefGoogle Scholar
  26. 26.
    Mandell D, Curtis R, Gold M, Hardie S. Anaphylaxis: how do you live with it? Health Soc Work 2005;30:325–35PubMedCrossRefGoogle Scholar
  27. 27.
    Herbert LJ, Dahlquist LM. Perceived history of anaphylaxis and parental overprotection, autonomy, anxiety, and depression in food allergic young adults. J Clin Psychol Med Settings 2008;15:261–9PubMedCrossRefGoogle Scholar
  28. 28.
    Knibb RC, Semper HM. Anxiety and depression in parents with food allergic children before and after food allergy diagnosis. Psychol Health 2008;23:161Google Scholar
  29. 29.
    Kelleher MM, Dunngalvin A, Sheikh A, Cullinane C, Fitzsimons J, Hourihane JO. Twenty four-hour helpline access to expert management advice for food-allergy-triggered anaphylaxis in infants, children and young people: a pragmatic, randomized controlled trial. Allergy 2013;68: 1598–604PubMedCrossRefGoogle Scholar
  30. 30.
    Simons FER, Clark S, Camargo CA Jr. Anaphylaxis in the community: learning from the survivors. J Allergy Clin Immunol 2009;124:301–6PubMedCrossRefGoogle Scholar
  31. 31.
    Arkwright PD, Farragher AJ. Factors determining the ability of parents to effectively administer intramuscular adrenaline to food allergic children. Pediatr Allergy Immunol 2006;17:227–9PubMedCrossRefGoogle Scholar
  32. 32.
    Sampson MA, Munoz-Furlong A, Sicherer SH. Risk-taking and coping strategies of adolescents and young adults with food allergy. J Allergy Clin Immunol 2006;117:1440–5PubMedCrossRefGoogle Scholar
  33. 33.
    Lyons AC, Forde EM. Food allergy in young adults: perceptions and psychological effects. J Health Psychol 2004;9:497–504PubMedCrossRefGoogle Scholar
  34. 34.
    Monks H, Gowland MH, MacKenzie H, Erlewyn-Lajeunesse M, King R, Lucas JS, Roberts G. How do teenagers manage their food allergies? Clin Exp Allergy 2010;40:1533–40PubMedCrossRefGoogle Scholar
  35. 35.
    Akeson N, Worth A, Sheikh A. The psychosocial impact of anaphylaxis on young people and their parents. Clin Exp Allergy 2007;37:1213–20PubMedCrossRefGoogle Scholar
  36. 36.
    Macadam C, Barnett J, Roberts G, Stiefel G, King R, Erlewyn-Lajeunesse M et al. What factors affect the carriage of epinephrine auto-injektors by teenagers. Clin Trans Allergy 2012;2:3CrossRefGoogle Scholar
  37. 37.
    Marrs T, Lack G. Why do few food-allergic adolescents treat anaphylaxis with adrenaline? — Reviewing a pressing issue. Pediatr Allergy Immunol 2013;24(3):222–9PubMedCrossRefGoogle Scholar
  38. 38.
    Le TM, Flokstra-de Blok BM, Hoffen E van, Lebens AF, Goossens NJ, Dubois AE et al. Quality of life is more impaired in patients seeking medical care for food allergy. Int Arch Allergy Immunol 2013;162:335–9PubMedCrossRefGoogle Scholar
  39. 39.
    Ellert U, Kurth BM. [Health-related quality of life in adults in Germany: results of the German Health Interview and Examination Survey for Adults (DEGS1)]. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 2013;56:643–9CrossRefGoogle Scholar
  40. 40.
    Jansson SA, Heibert-Arnlind M, Middelveld RJ, Bengtsson UJ, Sundqvist AC, Kallström-Bengtsson I. Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods. Clin Transl Allergy 2013;3:21PubMedCentralPubMedCrossRefGoogle Scholar
  41. 41.
    Kramer S, Franke A, Simon JC, Treudler R. Health related Quality of Life bei 73 Birkenpollenallergikern mit pollenassoziierter Nahrungsmittelallergie. Allergo J 2010;19:17Google Scholar
  42. 42.
    Kramer S, Simon JC, Treudler R. Birch associated soy allergy is frequent and causes impairment of quality of life. Allergy 2009;64:47Google Scholar
  43. 43.
    Cummings AJ, Knibb RC, Erlewyn-Lajeunesse M, King RM, Roberts G, Lucas JS. Management of nut allergy influences quality of life and anxiety in children and their mothers. Pediatr Allergy Immunol 2010;21:586–94PubMedCrossRefGoogle Scholar
  44. 44.
    Pinczower GD, Bertalli NA, Bussmann N, Hamidon M, Allen KJ, Dunngalvin A et al. The effect of provision of an adrenaline autoinjector on quality of life in children with food allergy. J Allergy Clin Immunol 2013;131:238–40PubMedCrossRefGoogle Scholar
  45. 45.
    Chad L, Ben-Shoshan M, Asai Y, Cherkaoui S, Alizadehfar R, St-Pierre Y et al. A majority of parents of children with peanut allergy fear using the epinephrine auto-injector. Allergy 2013;68:1605–9PubMedCrossRefGoogle Scholar
  46. 46.
    Gallagher M, Worth A, Cunningham-Burley S, Sheikh A. Epinephrine autoinjector use in adolescents at risk of anaphylaxis: a qualitative study in Scotland, UK. Clin Exp Allergy 2011;41:869–77PubMedCrossRefGoogle Scholar
  47. 47.
    Joshi P, Mofidi S, Sicherer SH. Interpretation of commercial food ingredient labels by parents of food-allergic children. J Allergy Clin Immunol 2002;109:1019–21PubMedCrossRefGoogle Scholar
  48. 48.
    Barnett J, Leftwich J, Muncer K, Grimshaw K, Shepherd R, Raats MM et al. How do peanut and nut-allergic consumers use information on the packaging to avoid allergens? Allergy 2011;66:969–78PubMedCrossRefGoogle Scholar
  49. 49.
    Barnett J, Vasileiou K, Gowland MH, Raats MM, Lucas JS. Beyond labelling: What strategies do nut allergic individuals employ to make food choices? A qualitative study. PLoS One 2013;8:e55293PubMedCentralPubMedCrossRefGoogle Scholar
  50. 50.
    Velde JL van der, Flokstra-de Blok BM, Groot H de, Oude-Elberink JN, Kerkhof M, Duiverman EJ et al. Food allergyrelated quality of life after double-blind, placebo-controlled food challenges in adults, adolescents, and children. J Allergy Clin Immunol 2012;130:1136–43PubMedCrossRefGoogle Scholar
  51. 51.
    Knibb RC, Ibrahim NF, Stiefel G, Petley R, Cummings AJ, King RM et al. The psychological impact of diagnostic food challenges to confirm the resolution of peanut or tree nut allergy. Clin Exp Allergy 2012;42:451–9PubMedCrossRefGoogle Scholar
  52. 52.
    DunnGalvin A, Cullinane C, Daly DA, Flokstra-de Blok BM, Dubois AE, Hourihane JO. Longitudinal validity and responsiveness of the Food Allergy Quality of Life Questionnaire - Parent Form in children 0-12 years following positive and negative food challenges. Clin Exp Allergy 2010;40:476–85PubMedCrossRefGoogle Scholar
  53. 53.
    Zijlstra WT, Flinterman AE, Soeters L, Knulst AC, Sinnema G, L’Hoir MP, Pasmans SG. Parental anxiety before and after food challenges in children with suspected peanut and hazelnut allergy. Pediatr Allergy Immunol 2010;21:439–45CrossRefGoogle Scholar
  54. 54.
    Finger A, Pfannenstiel C, Schönfelder A, Frank F, Buderus S, Lange L. Improvement of quality of life in children with milk and egg allergy after proof of tolerance to baked products. Allergy 2012;67;Suppl n96:87Google Scholar

Copyright information

© Urban & Vogel 2014

Authors and Affiliations

  1. 1.Department of PediatricsSt. Marien-HospitalBonnGermany

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