Quality of life of food-allergic patients before, during and following oral immunotherapy

Publication date: Available online 7 July 2018

Source: The Journal of Allergy and Clinical Immunology: In Practice

Author(s): Na'ama Epstein-Rigbi, Michael R. Goldberg, Michael B. Levy, Liat Nachshon, Arnon Elizur

Abstract

Background

Oral immunotherapy (OIT) for food allergy is demanding but data on patients' quality of life (QOL) throughout the process is limited.

Objective

To characterize changes in QOL of food-allergic patients during and following OIT.

Methods

In a prospective cohort study the FAQLQ-Parental Form (FAQLQ-PF) was administered to parents of 191 consecutive children aged 4-12 years, undergoing OIT for food allergy. Questionnaires were administered at OIT initiation, mid up-dosing, upon reaching maintenance and 6 months after. Age and gender- matched food-allergic children (n=48) not undergoing OIT served as controls.

Results

FAQOL-PF scores had significantly improved (decreased) from OIT initiation to reaching full (Total score; 3.69 to 3.19 p<0.001, Emotional Impact (EI); 3.66 to 3.32 p=0.001, Food Anxiety (FA); 3.90 to 3.32 p<0.001, Social and Dietary Limitation (SDL); 3.50 to 2.94 p<0.001) and partial maintenance, while no change was noted in control patients. Worse baseline QOL, single food allergy, and younger age, predicted greater QOL improvement. Of the 85/96 (88.5%) patients who completed the FAQLQ-PF at mid up-dosing and for whom QOL deteriorated, a significant improvement was noted upon reaching maintenance. Additional significant improvement in QOL was observed in the 95/107 (88.8%) patients who completed the FAQLQ-PF six months after reaching maintenance (Total; 3.266 to 2.614 P=0.001, EI; 3.414 to 2.993 P=0.049, FA; 3.37 to 2.593 P=0.001, SDL; 2.989 to 2.264 p=0.001).

Conclusions

QOL of food-allergic children improves significantly upon reaching OIT maintenance, with additional improvement 6 months later. The detrimental effect of OIT on some patients' QOL during up-dosing is reversed upon reaching maintenance.