(Oral Food) Challenges of improving quality of life for food allergy caregivers


Published Online August 29, 2014

Since food allergy primary affects children, the quality of life (QoL) of both the food allergic individual (FAI) and that of their caregivers may be affected.

In an article recently published in The Journal of Allergy and Clinical Immunology: In Practice, Franxman et al. explore differences in quality of life among caregivers of food allergic individuals (FAI) who underwent oral food challenge (OFC) versus those who had not.  

The researchers from the University of Michigan used a divisional database to identify patients who had undergone oral food challenge and surveyed their caregivers to gain a better understanding of how caring for a food allergic child affects their quality of life.  Using the validated Food Allergy Quality of Life—Parental Burden (FAQL-PB) instrument, data pertaining to quality of life among caregivers of food allergic patients who had participated in an OFC was collected and compared with data from caregivers of food allergic individuals who had not undergone OFC. The main study outcome was the mean difference in FAQL-PB score between these caregiver groups. Lower FAQL-PB score indicated a better quality of life.

115 caregivers of FAI undergoing OFC completed the QoL assessment, and were compared to 305 caregivers of FAI who had not undergone OFC. Caregivers of FAI undergoing OFC had significantly lower (better) QoL score than unchallenged controls.  Furthermore, within the challenged cohort, there was no significant difference in QoL score between those passing (e.g. not reacting) and failing (e.g. reacting from) OFC. Finally, in an adjusted regression model, QoL score was significantly lower among caregivers of FAI undergoing OFC and with income >$50,000, but significantly higher in caregivers responsible for multiple FAI or if the FAI had atopic dermatitis (eczema).

In this cohort, the authors demonstrated that OFC is associated with better caregiver QoL versus caregivers of unchallenged FAI.  Most importantly, there were no differences in mean QoL score between caregivers of those who passed and those who failed the challenge, which underscores that there is perhaps more value to (and less potential harm from) a failed OFC than previously perceived. The authors caution that further prospective, longitudinal study is needed to validate whether OFC can be used as an intervention to help improve food allergy quality of life.


The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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