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Measuring the impact of anaphylaxis on adults’ quality of life

Published: March 5, 2022

Anaphylaxis is a severe and potentially life-threatening allergic reaction to things such as food, medication, and insect stings. People can also have anaphylactic reactions where the cause is unknown, called spontaneous or idiopathic anaphylaxis. Anaphylaxis symptoms can include difficulty breathing, nausea and vomiting, skin rash and collapse and needs prompt treatment with epinephrine. It is known that anaphylaxis has a strong negative impact on the quality of life (QoL) of patients and can cause great anxiety and worry Day-to-day life can be severely affected in trying to avoid having an accidental reaction.  Questionnaires (known as scales) are currently available to measure QoL in patients who have allergies to food or venom, but until now no scales existed to specifically measure the impact of anaphylaxis on QoL. This scale could be used by clinicians or researchers, to see how the impact of anaphylaxis might differ across the different types of allergies, to direct allergy management advice and to help develop interventions to improve anaphylaxis management and QoL.

This study, published by Knibb et al (2022) in The Journal of Allergy and Clinical Immunology: In Practice, aimed to develop a validated scale to measure the impact of anaphylaxis on the QoL of adults. Participants were recruited from a specialist allergy clinic and had a confirmed diagnosis of anaphylaxis to food, drugs, venom, latex or had spontaneous anaphylaxis. Interviews were first conducted with 13 adults to explore how anaphylaxis had affected their lives. Their accounts were analyzed to look for common themes that described the impact the condition had on their QoL. These themes were then turned into questions for a QoL scale, which was then completed by 115 adults with anaphylaxis. In order to see how well this new scale related to other factors, participants also completed validated questionnaires to measure general QoL, anxiety, depression and stress. The results were analyzed to look at the reliability and validity of the new scale, to see how well it measures anaphylaxis related QoL.

The new scale, called the Anaphylaxis Quality of Life scale for Adults (A-QoL-Adults) has 21 questions, which make up the overall A-QoL-Adults score. The scale also has three internal sub-scales called Emotional Impact, Social Impact and Limitations on Life. The analysis of the data showed that all the questions in the scale related very well together (internal reliability) and all related to the other questionnaires that were completed (validity). Poorer anaphylaxis related QoL was significantly related to poorer general QoL, greater anxiety, stress and depression. The Q-QoL-Adults is therefore a reliable and valid measure of QoL in adults with anaphylaxis. It can offer healthcare professionals a means to further understand the impact of this condition on their adult patients, help direct and monitor allergy management and the need for further psychological support.

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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