US doctors not strong on food allergy knowledge

The results of a new study conducted in the US indicate that pediatricians and family physicians aren't always confident in their ability to diagnose or treat food allergies. The findings are based on an analysis of the web-based Chicago Food Allergy Research Survey for Pediatricians and Family Physicians which includes a national sample of pediatricians and family physicians recruited between April and July 2008.

More than 400 primary care physicians participated in the survey, with 99% of participants reportedly providing care for food-allergic patients. Based on their responses in the survey, most of the participants were proficient in identifying common childhood food allergies. However, they were less knowledgeable about the frequencies with which these allergies are outgrown. Most physicians surveyed in the study incorrectly identified chronic nasal congestion as a symptom of food allergy. Of greater concern, while the severity of food allergies and potential for anaphylaxis was acknowledged by the majority of participants, few knew the appropriate dosage of adrenaline needed for the treatment of anaphylaxis, nor were they aware that teenagers are at a greater risk of anaphylaxis fatalities compared to younger children.

Only 23% of the physicians recognised that dairy products such as yoghurts and cheeses made from cow's milk are unsafe for children with IgE–mediated allergy to milk. In addition, very few (less than 30%) of the participants felt comfortable interpreting laboratory tests to diagnose food allergy or felt adequately prepared by their medical training to care for food-allergic children.

The study authors concluded that such inconsistencies among primary care physicians contribute to uncertainties among caregivers and families. The results are being used by the research team 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.

Reference: Gupta et al. 2009. Pediatrics. Vol. 125(1) pp. 126-132. Doi:10.1542/peds.2009-1116