A Web site-based reporting system for monitoring home treatment during oral immunotherapy for food allergy.
BACKGROUND
Reactions during the home treatment phase of oral immunotherapy (OIT) are not uncommon. An ongoing accurate reporting of home treatment outcomes is crucial for the safety and success of OIT. Previous reports have shown that as few as 20% of patients are truly compliant with paper-based diaries.


OBJECTIVE
To develop a Web site-based electronic reporting system (web-RS) for monitoring home treatment during OIT for food allergy.


METHODS
A web-RS was developed and incorporated a thorough questionnaire querying for pertinent data including the dose(s) consumed, occurrence and details of adverse reactions, treatment(s), and relevant potential exacerbating factors. All patients enrolled in milk, peanut, or egg OIT programs for at least 4 weeks from November 2012 through January 2014 were introduced to web-RS (n = 157). Successful reporting through web-RS was defined by consecutive reporting during the first home treatment phase (24 days) after its introduction. Comparisons were made with a previous group of OIT-treated patients (n = 100) who reported by E-mail.


RESULTS
Successful reporting was achieved by 142 of 157 patients (90.44%) in contrast to a 75% success rate with E-mail (P = .0009). The odds for successful reporting using web-RS were 3.1 (95% confidence interval 1.6-6.3) times higher compared with using E-mail. Mild reactions were reported more frequently with web-RS (P = .0032). Patient reports were constantly available in real time for medical staff review. No complaints regarding web-RS feasibility were reported. One risk factor for failure to use web-RS was a patient's prior successful OIT experience without using web-RS (P = .012).


CONCLUSIONS
A web-RS can be a powerful tool for improving OIT safety by achieving a high level of patient cooperation in reporting home treatment results.
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Beer Yaakov, Israel.
Liat
L
Nachshon
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Beer Yaakov, Israel.
Michael R
MR
Goldberg
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Beer Yaakov, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Arnon
A
Elizur
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Beer Yaakov, Israel.
Michael B
MB
Levy
School of Public Health, University of Haifa, Haifa, Israel.
Naama
N
Schwartz
Allergy and Immunology Institute, Assaf-Harofeh Medical Center, Beer Yaakov, Israel; Department of Pediatrics, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: ykatz49@gmail.com.
Yitzhak
Y
Katz
D000284:Administration, Oral; D002648:Child; D003888:Desensitization, Immunologic / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005512:Food Hypersensitivity / Q000628:therapy*; D006801:Humans; D020407:Internet; D008297:Male; D010349:Patient Compliance; D012107:Research Design; D012189:Retrospective Studies; D012646:Self Administration; D057566:Self Report; D012984:Software; D011795:Surveys and Questionnaires; D016896:Treatment Outcome