title: Food allergy diagnosis and management practices among pediatricians.
abstract: Our goals were to (1) estimate the rates of parent-reported versus physician-diagnosed food allergy, (2) determine pediatrician adherence to national guidelines, and (3) obtain pediatricians' perspectives on guideline nonadherence. A mixed method approach was used, including survey, chart review, and qualitative methods. Overall, 10.9% of parents reported having a child with food allergy and two thirds of these cases were detected by the pediatrician. Chart reviews revealed high rates of guideline adherence with respect to allergist referral (67.3%), but less consistent adherence regarding documentation of reaction history (38.8%), appropriate use of diagnostic tests (34.7%), prescription of epinephrine autoinjectors (44.9%), and counseling families in food allergy management (24.5%). Pediatricians suggested that poor adherence was due to lack of documentation, familiarity with guidelines, and clarity regarding the pediatrician's role in managing food allergy. Findings emphasize the need to better establish the role of the pediatrician and to improve awareness and adherence to guidelines.
authors.affiliation: 1Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
authors.forename: Ruchi S
authors.initials: RS
authors.lastname: Gupta
authors.forename: Claudia H
authors.initials: CH
authors.lastname: Lau
authors.forename: Ashley A
authors.initials: AA
authors.lastname: Dyer
authors.forename: Min-Woong
authors.initials: MW
authors.lastname: Sohn
authors.forename: Barry A
authors.initials: BA
authors.lastname: Altshuler
authors.forename: Bennett A
authors.initials: BA
authors.lastname: Kaye
authors.forename: Jonathan
authors.initials: J
authors.lastname: Necheles
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003376:Counseling; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D010372:Pediatrics / Q000592:standards*; D010819:Physician's Role; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care
chemical_list: D004837:Epinephrine
keywords: food allergy; guidelines; management; pediatrics; primary care