title: Managing simple food allergy in community settings: A pilot study investigating a new model of care.
abstract: OBJECTIVE
  The prevalence of food allergy in Australia has increased, paralleled by an increase in waiting time to access tertiary paediatric allergy care. We aimed to test whether a new model of care, based on serum specific IgE testing, was feasible and acceptable to Australian families.
  
  
  METHODS
  A prospective pilot intervention study was conducted in community paediatric practices within 20-40 km of The Royal Children's Hospital, Melbourne. Children ≤7 years with likely food allergy referred to the Department of Allergy and Immunology at RCH were included; children with anaphylaxis, drug allergy or complex food allergy (>three food groups) were excluded. Community general paediatricians, recruited through the Australian Paediatric Research Network, were trained via webinars on the management of four common food allergy-related scenarios. Paediatrician and child and family parameters were assessed at baseline and 3 months, including safety.
  
  
  RESULTS
  34/45 (76%) eligible families and 10/12 (83%) paediatricians participated. Paediatricians managed 27/34 (80%) of children independently, with 7/34 (20%) requiring referral to an allergist for more complex food allergy. Paediatricians reported improved knowledge and competency in managing food allergy: (mean (standard deviation) scores pre = 35 (5.3) and post = 43.3 (3.9) training). The majority of children received appropriate management; there were no anaphylaxis episodes. There was no significant change in child quality of life or parent mental health.
  
  
  CONCLUSIONS
  Management of simple food allergy by community paediatricians appears feasible and acceptable to paediatricians and families alike. Future research will evaluate this approach in an adequately powered and controlled trial.
authors.affiliation: Murdoch Childrens Research Institute, Australian Paediatric Research Network (APRN), Melbourne, Victoria, Australia.|Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of General Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Danchin
authors.affiliation: Murdoch Childrens Research Institute, Australian Paediatric Research Network (APRN), Melbourne, Victoria, Australia.|Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.
authors.forename: Natalie
authors.initials: N
authors.lastname: De Bono
authors.affiliation: Murdoch Childrens Research Institute, Australian Paediatric Research Network (APRN), Melbourne, Victoria, Australia.|Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Allen
authors.affiliation: Murdoch Childrens Research Institute, Australian Paediatric Research Network (APRN), Melbourne, Victoria, Australia.|Department of Allergy and Immunology, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Mimi
authors.initials: M
authors.lastname: Tang
authors.affiliation: Murdoch Childrens Research Institute, Australian Paediatric Research Network (APRN), Melbourne, Victoria, Australia.|Centre for Community Child Health, Royal Children's Hospital, Melbourne, Victoria, Australia.|Department of Paediatrics, University of Melbourne, Melbourne, Victoria, Australia.
authors.forename: Harriet
authors.initials: H
authors.lastname: Hiscock
mesh_terms: D000072223:Allergists / Q000706:statistics & numerical data; D001315:Australia; D002648:Child; D002675:Child, Preschool; D003153:Community Health Services / Q000458:organization & administration*; D003661:Decision Support Techniques; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007400:Interprofessional Relations; D008297:Male; D009936:Organizational Innovation; D010348:Patient Care Team / Q000458:organization & administration*; D000072143:Pediatricians / Q000706:statistics & numerical data; D010865:Pilot Projects; D016730:Program Development; D015397:Program Evaluation; D011446:Prospective Studies; D012720:Severity of Illness Index
keywords: IgE; child; diagnosis; food allergy; management; paediatrician