Physicians knowledge of childhood food allergies needs room for improvement

December 09, 2009

With an estimated four to six percent of children in the U.S. suffering from food allergies, a new study shows that pediatricians and family physicians aren't always confident they have the ability to diagnose or treat food allergies.

A study published in the January 2010 issue of Pediatrics and headed by Dr. Ruchi Gupta, M.D., M.P.H., a researcher at Children's Memorial Hospital and Assistant Professor of Pediatrics at Northwestern University's Feinberg School of Medicine, brought attention to current knowledge gaps among primary care physicians in the diagnosis and management of food allergy. Researchers at Children's Memorial used the Chicago Food Allergy Research Survey for Pediatricians and Family Physicians to analyze physicians' knowledge and perceptions of food-related allergies in children. More than 400 pediatricians and family physicians across the nation responded to questions in areas ranging from the definition and diagnosis of food allergy to appropriate treatment and use of healthcare among affected children. Notably, 99 percent of those surveyed reported providing care for children with food allergy.

Participants' overall knowledge of food allergy was fair, with misconceptions and conflicting ideas commonly reported. For example, most participants incorrectly identified chronic nasal congestion as a symptom of food allergy. The majority of physicians were proficient in identifying common childhood food allergies however they were less knowledgeable about the frequencies with which these allergies are outgrown. While the severity of food allergies and potential for anaphylaxis was acknowledged among those surveyed, few knew the appropriate dosage of epinephrine in the treatment of anaphylaxis or that teenagers are at a greater risk of fatality due to anaphylaxis compared to younger children. Such inconsistencies among providers likely contribute to uncertainties among caregivers and families.

"Many physicians themselves reported not being comfortable with diagnosis, treatment, or interpreting labs for food allergies," says Dr. Gupta, "Understanding theses misconceptions will help us to create an intervention tool to close the knowledge gap." Dr. Gupta and her team are working to create a food allergy module that can easily be used by physicians in the office as a reference when providing care to food-allergic children.
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The research was completed by Ruchi Gupta, M.D., M.P.H.; Elizabeth E. Springston, A.B.; Jennifer S. Kim, M.D.; Bridget Smith, Ph.D.; Jacqueline A. Pongracic, M.D.; Xiaobin Wang, M.D., M.P.H., Sc.D.; and Jane Holl, M.D. M.P.H.

Children's Memorial is one of the top pediatric hospitals in the country according to U.S. News & World Report. It is the pediatric training center for Feinberg School of Medicine, Northwestern University.

Ann & Robert H. Lurie Children's Hospital of Chicago

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