RATIONALE: A prior survey of community pediatricians on food allergy diagnosis and management demonstrated gaps in knowledge and practice. Allergists often receive referrals from pediatricians after an initial evaluation for food allergy, so we sought to target pediatric residents to ensure they are equipped with the knowledge of new guidelines for early allergenic food introduction and appropriate diagnosis and management of food allergy. The goal is to ultimately eliminate unnecessary panel IgE testing and food avoidance, and downstream improvement in food allergy rates.
METHODS: We created an educational intervention for residents and preceptors at a pediatric academic center in the form of an on-line module with a pre-test, followed by a post-test one month later. We plan to analyze patient encounters identified based on food allergy ICD codes to obtain objective data on food allergy diagnosis (serum panel IgE testing vs. specific IgE testing, food avoidance, allergy referral, and distribution of epinephrine autoinjectors and food allergy action plans.) Measured outcomes will include changes in knowledge and practice.
RESULTS: Prior to the intervention, 14% of providers recommended food avoidance to a previously tolerated food based on lab findings, 68% recommended avoidance of foods associated with flares in atopic dermatitis, and 4% felt comfortable with the NIAID food allergy guidelines. Post-test results and chart review are pending.
CONCLUSIONS: The pre-test confirms the need for an educational intervention to teach the NIAID guidelines to pediatric residents and preceptors. Post-test analysis will provide more information regarding the efficacy of this intervention.