Treatment of allergic reactions and quality of life among caregivers of food-allergic children

Background: Caregivers of food-allergic individuals (FAIs) have decreased quality of life (QoL). The effects of epinephrine administration on QoL are poorly understood.

Objective: To investigate the relation between QoL and epinephrine use.

Methods: A de-identified 50-question online survey was administered to caregivers of FAIs across the United States through Web site, email, and social media networks of 2 national food allergy advocacy groups. QoL was assessed using the Food Allergy Quality of Life-Parental Burden questionnaire. The effect of prior epinephrine administration on QoL was analyzed using linear regression.

Results: Of 3,541 respondents, 35.6% reported their FAIs received epinephrine. Mean Food Allergy Quality of Life-Parental Burden scores were higher (worse QoL) in those reporting FAIs receiving epinephrine (3.07 vs 2.84, P < .001), anaphylaxis (3.01 vs 2.75, P < .001), multiple food allergies (3.16 vs 2.67, P < .001), and multiple food allergies and epinephrine use (3.24 vs 2.57, P < .001) vs those who did not. In a regression model, reported epinephrine use; anaphylaxis; multiple FAIs; multiple food allergies; and egg or milk, wheat or soy, or seafood allergy (vs peanut or tree nut allergy) were significantly associated with an increased (worse) QoL score. Caregiver college education and increasing FAI age were associated with a decreased QoL score (improved QoL). An interaction was noted between reported epinephrine use and anaphylaxis and was associated with a decreased QoL score.

Conclusion: The effect of epinephrine use on caregiver QoL is conditional and depends on reaction severity. Having multiple FAIs and FAIs with multiple food allergies was associated with worsening QoL. Further studies are needed to better understand the effects of treating an allergic reaction on caregiver QoL.