Simple tools increase pediatrician compatibility with guidelines for preventing allergies to early peanuts

Several easy -to -implement tools – training video, electronic hints and information materials for families – this has significantly increased how often pediatricians recommend the early introduction of peanuts into babies, informs a new clinical trial conducted by Northwestern University and Ann & Robert H. Lurie Children’s Hospital in Chicago.

From 2017, national guidelines have encouraged pediatricians to recommend the introduction of food containing peanuts about 4 to 6 months to reduce allergy to peanuts. However, surveys show that few pediatricians strictly follow these guidelines. An allergy to peanuts, the most common allergy to pediatric food, grows and affects over 2% of children in the USA

In the study, the attachment of the guidelines was 84% ​​for low -risk babies (no eczema and without egg allergies) in practices that the tools used, compared to 35% in clinics that do not. Infants in the intervention group were almost 15 times more vulnerable to care based on guidelines.

“We found that supporting pediatricians in training, electronic medical records and educational materials for parents has significantly improved their ability to advise families in early introduction of peanuts,” said the main author of Dr. Ruchi Gupta, a professor of pediatrics and medicine at Northwestern university feinberg school of medicine and pediatrician in Lurie Children’s.

Since pediatric visits at the age of 4 and 6 months are so busy, support is crucial for providing families with clear tips. We hope that these conversations will help parents feel confident by introducing earlier introduction of earth nuts. We want to reverse the trend of increasing food allergies in the US by preventing. “

Dr. Ruchi Gupta, professor, pediatrics and medicine, Northwestern University

The study will be published on Monday (October 6) in the journal.

How the test was carried out

The randomized study included 30 pediatric practices in Chicago and Peoria, Illinois, regions, including qualified federal health centers, private academic clinics and practices. Intervention practices received a film for clinicists’ training, electronic hints of medical documentation, visual aids for parents and a results card to identify heavy eczema; Control practices no.

The basic result was observing the guidelines of clinicians, documented in electronic health documentation (EHR) during a 4- or 6-month visit of good children’s. In total, 290 clinicists have observed 18,480 infants. In total, 290 clinicists have observed 18,480 infants.

Lucy Bilaver, the main statistics for the study and professor of pediatric care at Feinberg, noticed the importance of using EHR data for this pragmatic study. “We were able to measure the main result, using clinical and structural notes data generated by pediatrician clinicians during these well-child visits,” she said.

Arrangements

Among the low -risk babies, the attachment of the guidelines was 84% ​​in the intervention group compared to 35% in controls. In the case of high risk infants, the adjacent was 27% in the intervention group compared to 10% in controls. In addition, 36% of high -risk infants in the intervention group were referred to allergy or subjected to an allergy test compared to 10% in the control group.

“Although more work is needed, the success of this intervention is supported by wider dissemination to prevent allergy to peanuts in children,” said Gupta.

The results in the process will be followed until children are 2.5 years old to check whether the intervention will reduce the actual dissemination of nut allergies.

What parents should know

From 2017, national guidelines recommend introducing food containing peanuts around 4 to 6 months – a serious change led to a breakthrough clinical trial, which showed that the risk of nut allergy by over 80%. Earlier, parents often said that they delay the feeding of peanuts for fear that he could cause allergies.

When your child is developmental ready to start permanent, according to the authors of the research, you can introduce nut products. (Instructions on how to do it are related here.) It is also encouraged to introduce an egg and other widespread allergenic foods, based on family preferences.

The study, entitled “Pediatric guidelines for preventing nut allergies: randomized test”, was financed by the National Institute of Allergy and Infectious Diseases (Niaid U01Ai138907).