Food allergy symptom self-management with technology (FASST): An mHealth intervention to address psychosocial outcomes in caregivers of children with newly diagnosed food allergy: Protocol for a pilot randomized controlled trial. (Preprint)

BACKGROUND Approximately 2.4 million children in the United States suffer from food-induced anaphylaxis; a condition that is annually responsible for over 200 deaths and 200,000 emergency room visits. As a result, caregivers of children newly diagnosed with severe and life-threatening food allergic reactions experience clinically significant symptoms of psychological distress, including: fatigue, anxiety, depressed mood, social isolation, and substantially reduced quality of life. Despite this recognition, there is a lack of caregiver-centered self-management interventions to address these concerns. OBJECTIVE In this protocol, we propose to develop and conduct feasibility testing of a technology-enhanced, self-management mHealth smartphone app intervention Food Allergy Symptom Self-Management with Technology for Caregivers (FASST) designed to meet the psychosocial health needs of caregivers of children with a new diagnosis of food allergy. METHODS This pilot study uses pre-formative qualitative work (Phase I) to inform a 4 -week longitudinal randomized controlled trial (Phase II). In Phase I, 10 caregivers of children (<18 years old) with established food allergy (diagnosed  1 year) will participate in semi-structured interviews to inform the development of the FASST app. In Phase II, 30 caregivers of children with a newly diagnosed food allergy (diagnosed  90 days) will be randomized 2:1 to receive FASST intervention (n = 20) or the control condition (basic app with educational resources) (n = 10). Process measures include feasibility, caregiver acceptability, adherence and satisfaction. Outcome measures include caregiver fatigue, anxiety, depression, sleep, self-efficacy, and quality of life mesasured at baseline,week 4, and at 3-months post study completion. RESULTS Pre-formative Phase I study activities have been completed and Phase II participant enrollment into the randomized controlled trial is expected to commence 2021. CONCLUSIONS With limited readily available resources at their disposal, the results from this study have the potential to provide caregivers of children with a newly diagnosed food allergy a tool to help them self-manage and mitigate negative psychosocial factors during a critical time-period in the caregiving/condition trajectory. CLINICALTRIAL ClinicalTrials.gov Identifier NCT04512924 (posted 08/14/2020).

Actual antihistamine therapy

The significance of the issues of allergic diseases is not in doubt. It is difficult to find a person who has not suffered at least some Allergy symptom, not everyone develops diseases, but most people face Allergy symptoms. The prevalence of various allergic diseases is increasing every year, currently reaching 30% of the population, and the world health organization predicts it will reach 50% in the next few decades. The most common nosologies are allergic rhinitis, bronchial asthma, atopic dermatitis, urticaria, but there are many other conditions of hypersensitivity. This article addresses the issues of inflammatory reactions in General and specifically allergic inflammation, discusses the main aspects of the pathogenesis of allergic rhinitis and urticaria, and questions of drug therapy for these diseases. Most people are sure that they can take anti-allergic medications for allergies, and most often they are referring to antihistamines. Unfortunately, even some medical specialists lack an understanding of the specifics of antihistamine therapy. some people still believe that there are three or four generations of antihistamines, and patients use drugs not as prescribed by doctors, but on the recommendation of friends or pharmacists. Irrational use of antihistamines leads to a decrease in effectiveness, and it is not uncommon to discredit specific drugs and groups of drugs in General. This article demonstrates the results of various European and Asian studies on the effectiveness and safety of antihistamines and bilastin in particular, as well as their own experience of using antihistamines in practice.

Role of vitamin D3 supplementation in allergic rhinitis: an outpatient department based prospective analytical observational study

Background: Allergic rhinitis is a common disorder characterized by sneezing, rhinorrhoea, nasal congestion, itching and lacrimation which adversely affect quality of life to a substantial degree. Evidence suggests that low serum vitamin D3 has correlation with severity of allergic rhinitis. The objective of the study was to evaluate whether vitamin D3 supplementation has any role to reduce the severity of disease spectrum among allergic rhinitis patients.Methods: This prospective analytical observational study was carried out in 6 months in ENT OPD of Midnapore medical college and Hospital. Only the persistent moderate to severe allergic rhinitis patients as per ARIA-WHO guideline, aged >12 years were included in this study. 64 subjects were randomised into two groups. The test group received oral vitamin D (60000 IU/week for 2 months) along with levocetirizine, fluticasone spray and montelukast while the control group received three drug therapies without vitamin D3. Allergy symptom score (ASS) was assessed at the start and end of the study period.Results: The study population (n=64) was predominantly female (37) and had a mean age of 39.79 years. The ASS score was 14.06±1.01 in Test group and 13.93±1.01 in Control group and the Post treatment ASS score was 2.65±1.12 and 6.06±0.87 respectively. This difference between groups was significant (p<0.001).Conclusions: There was significant reduction in the Allergy symptom score after vitamin D3 supplementation which alters the course of disease towards clinical improvement.