A Buffer Against an Accidental Exposure is a Major Motivator for Entering a Child in Peanut Allergy Therapy
Monday, March 5, 2018
South Hall A2 (Convention Center)
Rebekah Marsh, MA, Hannah Gilbert, MS, Megan Morris, PhD, Matthew J. Greenhawt, MD MBA MSc
RATIONALE: Both Oral Immunotherapy (OIT) and epicutaneous immunotherapy (EPIT) are emerging potential treatments for peanut allergy. Caregiver goals and expectations of these therapies are poorly defined.

METHODS: 19 detailed, semi-structured interviews of OIT/EPIT participants were conducted to allow caregivers to describe their motivations for, and experiences with, therapy and life with a peanut allergic child.

RESULTS: Partial review of the coded transcripts to date show that caregivers of peanut allergic children enrolled in OIT/EPIT phase III trials clearly express a goal of therapy for their child to have a buffer against an accidental peanut exposure. The perception of the buffer varies by caregiver, and may represent decreased reaction severity upon exposure, increased time to react to allow for assessment by others, or increased threshold of peanut exposure tolerated. In general, these caregivers expressed that they do not anticipate this buffer, if achieved, would lessen their level of pre-therapy anxiety, allergen-associated vigilance or avoidance practices, despite hope these would change. Most of the caregivers hope the buffer will increase their (and the parent proxy-reported) perceived sense of freedom for the child’s actions and interactions, while still respecting the limitations of having a severe allergy that has been partially treated. Interestingly, some, but not all, caregivers have expressed that trial participation has decreased anxiety secondary to experiencing a severe allergic reaction that was promptly treated.

CONCLUSIONS: Preliminary analysis indicates that caregivers strongly desire OIT/EPIT results in a buffer against an accidental reaction, though most admitted that this would not change their anxiety and family’s current lifestyle.