Support Groups and an Anaphylaxis Management Plan Improve Adherence in Kids with Food Allergies

Do support groups help teenagers with diagnosed allergies adhere consistently to guidelines that protect them against anaphylaxis and other reactions? New research suggests they do.

A team of British researchers identified 188 adolescents with severe allergies by looking through prescriptions for epinephrine auto-injectors. Team members then correlated each patient’s self-care habits with factors that ranged from simple demographics to parental decisions to group membership to fundamental beliefs.

Patient records provided much of the data, while questionnaires provided the rest. The study team used the Health Belief Model to explore how patient attitudes and understanding influenced their actions.

Overall, only 16% of teens reported that they routinely complied in full with all the recommendations they received from their doctors, and only 4 factors correlated strongly enough with full compliance to achieve statistical significance.

“Membership of a patient support group and having an anaphylaxis management plan were associated with good adherence to self-care behaviours in adolescents with food allergy,” the study team wrote in Pediatric Allergy and Immunology.

Patients who belonged to support groups were actually more than twice as likely as their peers to report full compliance (Odds ratio, [OR] 2.54; 95% confidence interval [CI], 1.04-6.20).

Patients who had worked with caregivers to create an anaphylaxis management plan were also more likely than others to comply with self-care guidelines (OR, 3.22; 95% CI, 1.18-8.81), as were patients who perceived their food allergies to be more severe (OR, 1.24; 95% CI, 1.01-1.52).

Patients who perceived relatively few barriers to disease management, on the other hand, were less likely than other patients to take proper precautions for avoiding allergen and dealing with anaphylaxis (OR, 0.87; 95% CI, 0.79-0.96).

The researchers studied patients whose ages ranged from 13 to 19 years, but age did not predict patient behavior to any significant degree. Neither did sex, race, social class or any of the other factors the study team considered.

“Our results,” the study authors concluded, “suggest that interventions to improve provision and utilization of management plans, address adolescents’ perceptions of the severity of anaphylaxis and reduce barriers to disease management may facilitate good adherence behaviours better than focusing on knowledge-based interventions.”

The British study complements another study that Canadian researchers performed on teenagers with allergies a few months earlier.

That earlier study team held 3 focus groups to ask teens what they want from allergy education programs and published the highlights in Allergy, Asthma & Clinical Immunology.

Adolescents who participated in the focus groups said they often failed to follow best practices because they did not know best practices for all situations. Many said they were unsure about exactly what steps they should take to avoid allergens when they eat out or how cautious they should be about touching or kissing someone who may have come into contact with an allergen.

Mistaken certainties about correct behavior also made it impossible for some of the teens to comply fully with best practices. For example, some believed they could “wait out” or “sleep off” a reaction or that they could use a simple antihistamine as a first-line treatment and save the epinephrine until they started struggling to breathe or talk.

Support groups and anaphylaxis management plans could help prevent both problems, of course, though the Canadian teens expressed more interest in online educational resources, especially resources optimized for mobile use that would enable them to find answers to their questions in real time.