Health‐related quality of life, assessed with a disease‐specific questionnaire, in Swedish adults suffering from well‐diagnosed food allergy to staple foods

Abstract

BackgroundOur aim was to investigate the factors that affect health related quality of life (HRQL) in adult Swedish food allergic patients objectively diagnosed with allergy to at least one of the staple foods cow’s milk, hen’s egg or wheat. The number of foods involved, the type and severity of symptoms, as well as concomitant allergic disorders were assessed.MethodsThe disease-specific food allergy quality of life questionnaire (FAQLQ-AF), developed within EuroPrevall, was utilized. The questionnaire had four domains: Allergen Avoidance and Dietary Restrictions (AADR), Emotional Impact (EI), Risk of Accidental Exposure (RAE) and Food Allergy related Health (FAH). Comparisons were made with the outcome of the generic questionnaire EuroQol Health Questionnaire, 5 Dimensions (EQ-5D). The patients were recruited at an outpatient allergy clinic, based on a convincing history of food allergy supplemented by analysis of specific IgE to the foods in question. Seventy-nine patients participated (28 males, 51 females, mean-age 41 years).ResultsThe domain with the most negative impact on HRQL was AADR, assessing the patients’ experience of dietary restrictions. The domain with the least negative impact on HRQL was FAH, relating to health concerns due to the food allergy. One third of the patients had four concomitant allergic disorders, which had a negative impact on HRQL. Furthermore, asthma in combination with food allergy had a strong impact. Anaphylaxis, and particularly prescription of an epinephrine auto-injector, was associated with low HRQL. These effects were not seen using EQ-5D. Analyses of the symptoms revealed that oral allergy syndrome and cardiovascular symptoms had the greatest impact on HRQL. In contrast, no significant effect on HRQL was seen by the number of food allergies.ConclusionsThe FAQLQ-AF is a valid instrument, and more accurate among patients with allergy to staple foods in comparison to the commonly used generic EQ-5D. It adds important information on HRQL in food allergic adults. We found that the restrictions imposed on the patients due to the diet had the largest negative impact on HRQL. Both severity of the food allergy and the presence of concomitant allergic disorders had a profound impact on HRQL.

Health‐related quality of life in children with objectively diagnosed staple food allergy assessed with a disease‐specific questionnaire

“…Multiple concomitant allergic disorders were associated with worse HRQoL in children with allergy to staple foods. This finding parallels previous findings , including our report on HRQoL in Swedish adults with food allergy . Our results on number and type of symptoms align with previous findings that disease severity is an important risk factor in HRQoL among those with allergic disorders .…”

“…Using the validated disease‐specific questionnaire, Food Allergy Quality of Life Questionnaire, we recently reported on HRQoL in Swedish adults with allergies to the staple foods cow's milk, hen's egg and/or wheat . Herein, we sought to assess the disease‐specific HRQoL of Swedish children of 0–12 years old allergic to these foods, using the Food Allergy Quality of Life Questionnaire Parent‐Form (FAQLQ‐PF), which has been validated by others .…”

Measurement of health‐related quality of life in adult patients with birch pollen‐associated food allergy

“…Although one would expect that patients with severe immediate‐type reactions take their food allergy more seriously, are more careful in handling food, and are more anxious – given their past experience – than patients with milder symptoms, we were unable to ascertain a significant correlation between the severity of clinical reactions and the extent of HRQL impairment in our cohort. Other studies in adults as well as children and adolescents with and without anaphylaxis have yielded similar results . This may suggest that the patients’ personality structure plays a larger role in pollen‐associated FA than type and severity of symptoms, and that, therefore, patients with milder symptoms may also indeed experience impairment of their quality of life.…”

Messung der gesundheitsbezogenen Lebensqualität bei erwachsenen Patienten mit birkenpollenassoziierter Nahrungsmittelallergie

“…Obwohl man erwarten würde, dass Patienten mit schweren Soforttypreaktionen ihre Nahrungsmittelallergie ernster nehmen, vorsichtiger im Umgang mit Nahrungsmitteln sind und aufgrund ihrer Erfahrungen ängstlicher sind als Patienten mit milderen Symptomen, konnte in unserem Kollektiv kein signifikanter Zusammenhang zwischen Schweregrad der Reaktion und Stärke der Beeinträchtigung der HRQL ermittelt werden. Auch andere Untersuchungen an Erwachsenen sowie Kindern und Jugendlichen mit und ohne Anaphylaxie kamen zu diesem Ergebnis . Dies könnte dafür sprechen, dass bei der pollenassoziierten NMA weniger die Art und Schwere der Symptome, sondern mehr die Persönlichkeitsstruktur der Patienten eine Rolle spielt und daher auch Patienten mit milden Symptomen durchaus eine Beeinträchtigung ihrer Lebensqualität haben können.…”