The Psychological Impact of Oral Immunotherapy for Children With Food Allergy: Perceived Benefits and Treatment Burden

Abstract

Food allergy has a significant impact on child and family quality of life. Although there is currently no cure for food allergy, oral immunotherapy (OIT) has shown promise in desensitizing patients to food allergens. The primary aim of this paper was to examine the psychological impact of participation in OIT for children and families, including both perceived benefits and treatment burden. Semistructured interviews about the OIT experience were conducted with 10 children receiving OIT for milk allergy and their parents, and an inductive, grounded process was used to identify the most common categories of interview responses. Research documents were reviewed in a sample of 13 children receiving OIT for peanut allergy, to identify the nature and frequency of visits with a pediatric psychologist who was included as a member of the interdisciplinary research team. Following OIT for milk allergy, positive changes including increased dietary options, increased inclusion in social situations, and decreased anxiety about reactions were reported. Sources of treatment burden included anxiety about ingesting milk and injection-related distress. During OIT for peanut allergy, 69.2% of children met with the psychologist, with the most common presenting concerns including aversion to the taste of peanut, anxiety about ingestion of peanut, and injection-related distress. Children and families report perceived psychosocial benefits following OIT; however, there is also burden associated with the treatment itself. Preliminary experience suggests a role for pediatric psychologists to help children and families cope with and enhance adherence to OIT protocols.