Largest European Qualitative Study on Peanut Allergy Highlights Negative Impact of Avoidance and Fear of Accidental Peanut Allergy Reactions on Allergic Individuals and Their Caregivers
“In their own words, children, teens and their caregivers revealed the day-to-day difficulties of living with peanut allergy and how the lack of societal awareness impacts their emotional and social development, thereby suggesting a widespread need for improved quality of peanut allergy health management and education,” said Audrey DunnGalvin, Ph.D., an investigator on both the APPEAL-1 and APPEAL-2 projects and a lecturer in the
APPEAL-2 was designed to further explore key areas of impact identified in the two-part APPEAL-1 study (Allergy. 2020;00:1-10.; Allergy. 2020;00:1-16) which found that individuals experience frustration, stress, uncertainty and low levels of confidence in managing their peanut allergy. The open access manuscript, entitled “APPEAL-2: a pan-European qualitative study to explore the burden of peanut-allergic children, teenagers, and their caregivers,” is published online and can be accessed through the following link: https://onlinelibrary.wiley.com/doi/10.1111/cea.13719.
“The results of APPEAL-2 reinforce the findings of APPEAL-1 and further underscore that peanut-allergic individuals are more likely to experience feeling different, isolated, and restricted from social activities than their peers; their caregivers more often experience stress and adverse impacts on work and career,” said
Key Findings include:
Children and Teens
- Most teenagers reported negative experiences when going to restaurants with friends, including embarrassment at having to declare their PA or being treated unkindly by staff.
- Almost a third of children and a small number of teenagers did not want others to know about their PA and actively chose not to disclose it, some because of embarrassment, others to avoid teasing or bullying.
- Almost all children and teenagers reported a negative impact of PA on their social activities. For children and teens, using “avoidance” as a strategy of disease management included not only restaurants, but avoidance of certain places (e.g., school, cinemas) and missing activities with friends.
- Children and teenagers felt left out or envious due to being unable to attend social events and share food with others; several participants reported incidents of teasing and/or bullying.
- A quarter of teens reported an impact on dating and on boyfriend/girlfriend relationships.
- Over a third reported that their child’s PA had a negative impact on their work and/or career, including having to take time off and decreasing their working hours, demonstrating the potential socioeconomic impacts.
- For caregivers, buying and preparing food was a major, time-consuming aspect of managing their child’s PA.
- Caregivers often mentioned needing to determine suitable places to eat and the distance to a hospital or pharmacy beforehand.
- Almost a quarter of caregivers preferred to avoid social events if peanuts were served or if they would have no control over the environment.
- Some caregivers (parents) did not allow their children to attend social events, causing children to “miss out” on many social activities.
- Caregiver anxiety was rooted in a lack of control; approximately half reported worrying about having less control of their child’s food and environment as the child became more independent.
Results also uncovered opportunities to reduce the burden of living and coping with PA including: the importance of education to increase awareness and understanding of PA in both the general public and healthcare professionals across
Nederlands Anafylaxis Netwerk, The Anaphylaxis Campaign, Deutscher Allergie- und Asthmabund, Food Allergy Italia, Asociación Española de Personas con Alergia a Alimentos y Látex, Association Française pour la Prévention des Allergies, and Astma-Allergi Danmark contributed to the study design of the APPEAL Study.
About the APPEAL Studies
APPEAL-1 (Allergy to Peanuts ImPacting Emotions And Life 1) collected data from 1,846 participants in eight European countries and was the first pan-European quantitative, cross-sectional survey that explored the burden and psychosocial impact of living with PA with use of a novel questionnaire. Full results were published in Allergy in
About Peanut Allergy
Peanut allergy is one of the most common food allergies, which affects over 17 million people in
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