title: Factors impacting parental burden in food-allergic children.
abstract: OBJECTIVE
  This study aims to determine factors impacting the parental burden in immunoglobulin E (IgE)-mediated food-allergic children (FAC), focusing on attitudes towards adrenaline autoinjectors (AAIs).
  
  
  METHODS
  Questionnaires were sent to parents of diagnosed IgE-mediated FAC attending follow-up allergy clinic appointments at two Sydney hospitals in May-September 2013. The questionnaires ascertained parental attitudes, confidence and knowledge regarding AAIs and included the validated, Food Allergy Quality of Life-Parental Burden (FAQL-PB) questionnaire.
  
  
  RESULTS
  The response rate was 68%. Of FAC, 62% were male aged 1-17 years (median 6.0). There was a high proportion of children with multiple food allergies (52% allergic to >2 foods), coexistant eczema (85%) and asthma (54%). Sixty-three per cent reported a past history of anaphylaxis and 42% reported reactions in the last 6 months. AAI had been prescribed for 84%. FAC with a history of anaphylaxis were more likely to have had an AAI prescribed (P < 0.0001). There was no difference in FAQL-PB mean scores with age or AAI prescription status. The PB score was greater if the parent had administered the AAI (P = 0.02) and where the child was allergic to >2 foods (P < 0.0001).The Ninety per cent of parents reported that the AAI increased or did not change the child's quality of life, the family or FACs freedom. Three per cent of parents whose FAC children were prescribed an AAI reported increased stress related to AAI prescription.
  
  
  CONCLUSIONS
  Severity of food allergy, number of food allergens and past anaphylaxis rather than prescription of an AAI appear to be major influences on parental burden.
authors.affiliation: Department of General Medicine, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.|Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.|Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Clare W
authors.initials: CW
authors.lastname: Allen
authors.affiliation: Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.|Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Manasee S
authors.initials: MS
authors.lastname: Bidarkar
authors.affiliation: Sydney Medical School - Northern, University of Sydney, Sydney, New South Wales, Australia.|Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, New South Wales, Australia.
authors.forename: Sheryl A
authors.initials: SA
authors.lastname: vanNunen
authors.affiliation: Allergy and Immunology, The Children's Hospital at Westmead, Sydney, New South Wales, Australia.|Discipline of Paediatrics and Child Health, University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Dianne E
authors.initials: DE
authors.lastname: Campbell
mesh_terms: D000293:Adolescent; D000707:Anaphylaxis / Q000188:drug therapy / Q000276:immunology / Q000523:psychology*; D001294:Attitude to Health; D002648:Child; D002675:Child, Preschool; D017281:Cost of Illness; D004837:Epinephrine / Q000627:therapeutic use; D005260:Female; D005512:Food Hypersensitivity / Q000188:drug therapy / Q000276:immunology / Q000523:psychology*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007073:Immunoglobulin E; D007223:Infant; D007267:Injections; D008297:Male; D010290:Parents / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013566:Sympathomimetics / Q000627:therapeutic use
chemical_list: D013566:Sympathomimetics; D007073:Immunoglobulin E; D004837:Epinephrine
keywords: adrenaline auto injector; food allergy; parental burden; quality of life