Abstract
Background: Food allergy disproportionately affects children and contributes to poor quality of life for families. As a result, accurate diagnosis of food allergy is important. Oral food challenges (OFC) are the gold standard test for diagnosis of food allergy. Yet, many children do not undergo OFCs. The purpose of this study was to understand the barriers to OFCs faced by parents of children with food allergies in Ontario, as well as solutions to increase their utilization.Methods: Three focus group discussions were carried out with a total of 24 parents of children with food allergies in Kitchener-Waterloo, Ontario. Focus group data were analyzed using constant comparative analysis.Results: Parents misperceived OFCs as management of food allergies. They were also unsure about whether OFCs take place in hospitals, clinics or in the home. Parents reported several barriers to OFCs including not being referred by their primary care physicians, wait times, and fear and anxiety. Additionally, parents with older children, children with multiple allergies and children who could only tolerate allergens in its baked form felt that OFCs would not improve their quality of life. Solutions offered by parents to increase uptake of OFCs included education of the public, physicians and policy makers to improve knowledge and training, and ensure timely access to OFCs. Parents also suggested a need for improved counselling about the risk of OFCs, psychological support, and sharing of patient success stories. Long-term follow-up after an OFC as well as support and guidance around food reintroduction was also suggested to ensure OFCs resulted in an improvement in quality of life.Conclusion: Interventions aimed at addressing barriers to OFCs identified by parents have the potential to increase utilization of OFCs, and thereby reduce the burden of food allergies in children and improve quality of life.
Challenges in Diagnosis of Food Allergies via Oral Food Challenges: A Qualitative Analysis of the Caregiver Perspective
