Publications
375 results found
Munblit D, Perkin MR, Palmer DJ, et al., 2020, Assessment of evidence about common infant symptoms and cow’s milk allergy, JAMA Pediatrics, Vol: 174, Pages: 599-608, ISSN: 2168-6203
Importance Sales of specialized formula for managing cow’s milk allergy (CMA) have increased, triggering concern that attribution of common infant symptoms, such as crying, vomiting, and rashes, to CMA may be leading to overdiagnosis, which could undermine breastfeeding.Objective To understand whether CMA guideline recommendations might promote CMA overdiagnosis or undermine breastfeeding.Evidence Review We reviewed recommendations made in CMA guidelines and critically appraised 2 key recommendations. First, we reviewed relevant literature summarizing whether maternal or infant dietary exclusion of cow’s milk is effective for managing common infant symptoms. Second, we reviewed published data on breastmilk composition and thresholds of reactivity in CMA to estimate the probability that cow’s milk protein in human breastmilk can trigger symptoms in infants with CMA. We also documented the level of commercial involvement in CMA guidelines.Findings We reviewed 9 CMA guidelines published from 2012 to 2019. Seven suggest considering CMA as a cause of common infant symptoms. Seven recommend strict maternal cow’s milk exclusion for managing common symptoms in breastfed infants. We found CMA proven by food challenge affects approximately 1% of infants, while troublesome crying, vomiting, or rashes are each reported in 15% to 20% of infants. We found clinical trials do not provide consistent support for using maternal or infant cow’s milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for more than 99% infants with proven CMA, the breastmilk of a cow’s milk–consuming woman contains insufficient milk allergen to trigger an allergic reaction. Three CMA guidelines were directly supported by formula manufacturers or marketing consultants, and 81% of all guideline authors reported a conflict of interest with formula manufacturers.Conclusions and Relevance Recommendations to manage common infant s
Teh JJ, Cheung KY, Patrick Y, et al., 2020, The value of paediatrics placements: confidence or competence? [response to letter], Advances in Medical Education and Practice, Vol: 11, Pages: 269-270, ISSN: 1179-7258
de Silva D, Halken S, Singh C, et al., 2020, Preventing immediate-onset food allergy in infants, children and adults: Systematic review protocol, PEDIATRIC ALLERGY AND IMMUNOLOGY, Vol: 31, Pages: 243-249, ISSN: 0905-6157
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- Citations: 11
Chalmers JR, Haines RH, Bradshaw LE, et al., 2020, Daily emollient during infancy for prevention of eczema: the BEEP randomised controlled trial, The Lancet, Vol: 395, Pages: 962-972, ISSN: 0140-6736
BackgroundSkin barrier dysfunction precedes eczema development. We tested whether daily use of emollient in the first year could prevent eczema in high-risk children.MethodsWe did a multicentre, pragmatic, parallel-group, randomised controlled trial in 12 hospitals and four primary care sites across the UK. Families were approached via antenatal or postnatal services for recruitment of term infants (at least 37 weeks' gestation) at high risk of developing eczema (ie, at least one first-degree relative with parent-reported eczema, allergic rhinitis, or asthma, diagnosed by a doctor). Term newborns with a family history of atopic disease were randomly assigned (1:1) to application of emollient daily (either Diprobase cream or DoubleBase gel) for the first year plus standard skin-care advice (emollient group) or standard skin-care advice only (control group). The randomisation schedule was created using computer-generated code (stratified by recruiting centre and number of first-degree relatives with atopic disease) and participants were assigned to groups using an internet-based randomisation system. The primary outcome was eczema at age 2 years (defined by UK working party criteria) with analysis as randomised regardless of adherence to allocation for participants with outcome data collected, and adjusting for stratification variables. This trial is registered with ISRCTN, ISRCTN21528841. Data collection for long-term follow-up is ongoing, but the trial is closed to recruitment.Findings1394 newborns were randomly assigned to study groups between Nov 19, 2014, and Nov 18, 2016; 693 were assigned to the emollient group and 701 to the control group. Adherence in the emollient group was 88% (466 of 532) at 3 months, 82% (427 of 519) at 6 months, and 74% (375 of 506) at 12 months in those with complete questionnaire data. At age 2 years, eczema was present in 139 (23%) of 598 infants with outcome data collected in the emollient group and 150 (25%) of 612 infants in the co
Kelleher MM, Jay N, Perkin MR, et al., 2020, An algorithm for diagnosing IgE-mediated food allergy in study participants who do not undergo food challenge, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 50, Pages: 334-342, ISSN: 0954-7894
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- Citations: 15
Panahi M, Teh J, Cheung K, et al., 2020, Self-perceived confidence of medical students communicating with pediatric patients in a 7-week pediatric placement: a pilot survey, Advances in Medical Education and Practice, Vol: 11, Pages: 163169-163169, ISSN: 1179-7258
Background: Pediatrics is a specialty reserved until later stages of the medical curriculum, with many students receiving early exposure via volunteering opportunities. Self-perceived confidence across the pediatric curriculum is crucial, due to limited clinical exposure before qualification. We aimed to assess the impact of a 7-week pediatric placement on medical students’ self-perceived confidence and factors that influenced self-perceived confidence.Methods: We conducted a prospective pilot survey on three cohorts of fifth-year students undertaking pediatric placements in 2018. A two-part questionnaire was distributed before and after the placement, evaluating the level of self-confidence in clinical skills using a 10-point scale.Results: Of 103 students, 62 (60%) students completed both questionnaires. Of these, 34 (55%) students reported previous professional experiences with children. There was a significant increase in self-reported confidence scores across ten questions before (mean 5.4 [IQR 4.1– 6.1]) and after the placement (7.6 [6.6– 8.5], p< 0.0001). Subgroup analyses between students with prior professional experience with children and those without revealed a significant difference in preplacement confidence in four pediatric practices: verbal communication, physical engagement, asking sensitive or probing questions, and explaining medical management (p< 0.05). There was no significant difference in postplacement confidence between these two groups.Conclusion: Medical students with prior professional experience with children reported higher self-confidence in interacting with pediatric patients prior to placement. However, a large and consistent increase in confidence across the cohort was such that there were no measurable differences at exit. This study supports the value of undergraduate pediatric training in promoting student self-confidence in managing pediatric clinical issues.
Kelleher MM, Cro S, Cornelius V, et al., 2020, Skincare interventions in infants for preventing eczema and food allergy, Cochrane Database of Systematic Reviews, Vol: 2020
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows:. Primary objective. To assess the effects of skincare interventions, such as emollients, for prevention of eczema and food allergy in infants. Secondary objectives. To ascertain whether active skincare interventions, commenced in early infancy, influence risk of developing eczema or food allergy To identify features of the study populations such as age, hereditary risk and adherence to the interventions, which are associated with the greatest treatment benefit or harm for both eczema and food allergy.
Dua S, DOwey J, Garcia MR, et al., 2020, How Reaction Severity Is Affected By Cofactors And Repeat Challenges: A Prospective Study Of Peanut Allergic Adults, Annual Meeting of the American-Academy-of-Allergy-Asthma-and-Immunology (AAAAI), Publisher: MOSBY-ELSEVIER, Pages: AB182-AB182, ISSN: 0091-6749
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- Citations: 1
Kelleher MM, Tran L, Boyle RJ, 2020, Prevention of food allergy - skin barrier interventions, ALLERGOLOGY INTERNATIONAL, Vol: 69, Pages: 3-10, ISSN: 1323-8930
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- Citations: 13
Boyle R, Wilkins P, 2020, Managing Reputational Risk, CROSSOVER OF AUDIT AND EVALUATION PRACTICES: CHALLENGES AND OPPORTUNITIES, Editors: Barrados, Lonsdale, Publisher: ROUTLEDGE, Pages: 87-100, ISBN: 978-0-367-89770-3
Clement C, Ridd MJ, Roberts K, et al., 2020, Parents and GPs' understandings and beliefs about food allergy testing in children with eczema: qualitative interview study within the Trial of Eczema allergy Screening Tests (TEST) feasibility trial, BMJ OPEN, Vol: 10, ISSN: 2044-6055
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- Citations: 4
Jarrold K, Helfer B, Eskander M, et al., 2019, Guidance for the conduct and reporting of clinical trials of breastmilk substitutes: a Delphi consensus statement, JAMA Pediatrics, ISSN: 2168-6203
Importance: Breastmilk substitutes (BMS) are important nutritional products evaluated in clinical trials. Concerns have been raised about the risk of bias in BMS trials, the reliability of claims which arise from such trials, and the potential for BMS trials to undermine breastfeeding in trial participants. Existing clinical trial guidance68 does not fully address issues specific to BMS trials. Objective: To establish new methodological criteria to guide the design, conduct, analysis and reporting of BMS trials. To support clinical trialists designing and undertaking BMS trials, editors and peer reviewers assessing trial reports for publication, and regulators evaluating the safety, nutritional adequacy and efficacy of BMS products. Design, Setting, and Participants A modified Delphi method involving 3 rounds of anonymous questionnaires and a face-to-face consensus meeting between January and October 2018. Participants were 23 experts in BMS trials, BMS regulation, trial methodology, breastfeeding support, infant feeding research and medical publishing, affiliated with institutions across Europe, North America and Australasia. Guidance development was supported by an industry consultation, analysis of methodological issues in a sample of published BMS trials, and consultations with BMS trial 81 participants and a research ethics committee. Results: An initial 73 criteria, derived from the literature, were sent to the experts. The final consensus guidance contains a total of 54 essential and 4 recommended criteria. An 18-point checklist summarizes those criteria which are specific to BMS 5 trials. Key themes emphasised in the guidance are research integrity and transparency of reporting, supporting breastfeeding in trial participants, accurate description of trial interventions and use of valid and meaningful outcome measures. Conclusions and Relevance: Implementation of this guidance should enhance the quality and validity of BMS trials, protect BMS trial particip
Ridd M, Chalmer J, Boyle R, et al., 2019, Daily emollient for the first year of life for preventing eczema: results of the BEEP randomised trial, Publisher: WILEY, Pages: 1654-1654, ISSN: 0954-7894
Roberts G, Almqvist C, Boyle R, et al., 2019, Developments in the mechanisms of allergy in 2018 through the eyes of Clinical and Experimental Allergy, Part I, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 49, Pages: 1541-1549, ISSN: 0954-7894
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- Citations: 2
Roberts G, Grimshaw K, Beyer K, et al., 2019, Can dietary strategies in early life prevent childhood food allergy? A report from two iFAAM workshops, Clinical and Experimental Allergy, Vol: 49, Pages: 1567-1577, ISSN: 0954-7894
Food allergy affects a small but significant number of children and adults. Food allergy is responsible for considerable morbidity and is the commonest cause of anaphylaxis in children. One of the aims of the European Union‐funded “Integrated Approaches to Food Allergen and Allergy Risk Management” (iFAAM) project was to improve our understanding of the best way to prevent the development of food allergy. Groups within the project worked on integrating the current prevention evidence base as well as generating new data to move our understanding forward. This paper from the iFAAM project is a unique addition to the literature on this topic as it not only outlines the recently published randomized controlled trials (as have previous reviews) but also summarizes two iFAAM‐associated project workshops. These workshops focused on how we may be able to use dietary strategies in early life to prevent the development of food allergy and summarized the range of opinions amongst experts in this controversial area.
Jaiswal AJ, Conrad A, Dempsey J, et al., 2019, Evaluation of the sufficiency and feasibility of modified PRACTALL oral food challenge dosing schedules, Publisher: WILEY, Pages: 1656-1656, ISSN: 0954-7894
Dua S, Ruiz-Garcia M, Bond S, et al., 2019, The effect of sleep deprivation and exercise on reaction threshold in peanut-allergic adults: a randomised controlled study, Journal of Allergy and Clinical Immunology, Vol: 144, Pages: 1584-1594.e2, ISSN: 0091-6749
BACKGROUND: Peanut allergy causes severe and fatal reactions. Current food allergen labelling fails to address these risks adequately against the burden of restricting food choice for allergic individuals because of limited data on thresholds of reactivity and the influence of everyday factors. OBJECTIVE: We estimated peanut threshold doses for a UK peanut-allergic population and examined the effect of sleep deprivation and exercise. METHOD: In a crossover study, following blinded challenge, peanut-allergic participants underwent three open peanut challenges in random order: with exercise following each dose, with sleep deprivation preceding challenge, and with no intervention. Primary outcome was the threshold dose triggering symptoms (mg protein). Primary analysis estimated the difference between non-intervention challenge and each intervention in log threshold (as % change). Dose distributions were modelled deriving eliciting doses in the peanut-allergic population. RESULTS: Baseline challenges were performed in 126 subjects, 100 were randomized and 81 (mean age 25y) completed at least one further challenge. The mean (SD) threshold was 214 mg (330mg) for non-intervention challenges and this was reduced by 45% (95% confidence interval 21,61 p=0.001) and 45% (22,62 p=0.001) for exercise and sleep deprivation, respectively. Mean (95% confidence interval) estimated eliciting doses for 1% of the population were 1.5mg (0.8,2.5) during non-intervention challenge (n=81), 0.5mg (0.2,0.8) following sleep and 0.3mg (0.1,0.6) following exercise. CONCLUSION: Exercise and sleep deprivation each significantly reduce the threshold of reactivity in people with peanut allergy, putting them at greater risk of a reaction. Adjusting reference doses using these data will improve allergen risk-management and labelling to optimize protection of peanut-allergic consumers.
Roberts G, Almqvist C, Boyle R, et al., 2019, Developments in the field of clinical allergy in 2018 through the eyes of Clinical and Experimental Allergy, Part II, CLINICAL AND EXPERIMENTAL ALLERGY, Vol: 49, Pages: 1550-1557, ISSN: 0954-7894
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- Citations: 1
Munblit D, Perkin MR, Palmer DJ, et al., 2019, Attributing common infant symptoms to cow’s milk allergy, JAMA Pediatrics, ISSN: 2168-6203
Background: Sales of specialised formula for managing cow’s milk allergy (CMA) have increased, triggering concern that attribution of common infant symptoms such as crying, vomiting and rashes to CMA may be leading to overdiagnosis, which could undermine breastfeeding. Objective: To understand whether CMA guideline recommendations might promote CMA over diagnosis or undermine breastfeeding. Methods: We reviewed recommendations made in CMA guidelines and critically appraised two key recommendations. First, we reviewed relevant literature 36summarisingwhether maternal or infant dietary exclusion of cow’s milk is effective for managing common infant symptoms. Second, we reviewedpublished data on breastmilk compositionand thresholds of reactivity in CMA,to estimate the probability that cow’s milk protein in human breastmilk can trigger symptoms in infantswith CMA. We also documentedthe level of commercial involvement in CMA guidelines. Findings: We reviewed nineCMA guidelinespublished from2012-19. Seven suggest consideringCMA as a cause ofcommon infant symptoms.Seven recommend strict maternal cow’s milk exclusion for managing common symptoms in breastfed infants. We found CMA proven by food challenge affects ~1% of infants, while troublesome crying, vomiting orrashesare each reported in 15-20% of infants. We found clinical trials don’t provide consistent support for usingmaternal or infant cow’s milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for >99% infantswith proven CMA the breastmilk of a cow’s milk consuming woman contains insufficient milk allergen to trigger an allergic reaction. Three CMA guidelines were directly supported by formula manufacturers or marketing consultants and 81% of all guideline authors reported aconflict of interest with formula manufacturers. Conclusions: Recommendations to manage common infant symptoms as CMA are not evidence-based, especially in breastfe
Blyuss O, Cheung KY, Chen J, et al., 2019, Statistical approaches in the studies assessing associations between human milk immune composition and allergic diseases: A scoping review, Nutrients, Vol: 11, Pages: 1-15, ISSN: 2072-6643
A growing number of studies are focusing on the associations between human milk (HM) immunological composition and allergic diseases. This scoping review aims to identify statistical methods applied in the field and highlight pitfalls and unmet needs. A comprehensive literature search in MEDLINE and Embase retrieved 13,607 unique records. Following title/abstract screening, 29 studies met the selection criteria and were included in this review. We found that definitions of colostrum and mature milk varied across the studies. A total of 17 out of 29 (59%) studies collected samples longitudinally, but only 12% of these used serial (longitudinal) analyses. Multivariable analysis was used in 45% of the studies, but statistical approaches to modelling varied largely across the studies. Types of variables included as potential confounding factors differed considerably between models. Discrimination analysis was absent from all studies and only a single study reported classification measures. Outcomes of this scoping review highlight lack of standardization, both in data collection and handling, which remains one of the main challenges in the field. Improved standardization could be obtained by a consensus group of researchers and clinicians that could recommend appropriate methods to be applied in future prospective studies, as well as already existing datasets.
Bramer S, Hazemi-Jebelli Y, Weaver G, et al., 2019, The provision of donor human milk beyond the NICU, Academy for Breastfeeding Medicine, Publisher: Mary Ann Liebert, ISSN: 1556-8253
Background: In the UK, to date, there is little evidence to support the safe use of donor human milk (DHM) from a human milk bank beyond extremely premature babies in neonatal intensive care units. The HMB operates as part of a new charity, the Human Milk Foundation, and foremost aim to fill gaps in the provision of donor human milk (DHM) to hospital neonatal units. Secondary aims of the HMB are to facilitate research into operational aspects of human milk banking, the clinical use of DHM and the science of human milk.Objective(s): This study aimed to assess the growth and tolerance of infants provided with DHM from the Hearts Milk Bank (HMB) in the UK over the course of their first 18 months of operation, as well as the range of indications for which DHM was provided. The study also aimed to understand the impact of DHM use on infant and mother from this case series, and provide the first national and international profile of DHM usage beyond extremely premature babies cared for in NICUs.Materials/Methods: Interviews were conducted over the telephone with follow up questions answered by email when required. All interviews were conducted at the Hearts Milk Bank premises, and no identifiable data left the milk bank premises. Questionnaires were sent electronically using Qualtics to all UK‐based milk banks as well as milk banks internationally, including North America, Europe and Australia, to determine the provision of DHM beyond the NICU. Finally, infant feeding leads in hospitals offering maternity and paediatrics care across the UK was surveyed using a Qualtrics questionnaire to understand the geographical variability in DHM provision, and to understand the reasons that underpinned this. This study was assessed as a service evaluation project by the Imperial Research Ethics team, and formal ethics was not required.Conclusions: DHM that is surplus to the requirements of hospitals has been provided to more than 40 families in the community for a range of indications
Jarrold K, Helfer B, Boyle RJ, 2019, Designing Scientifically Valid Infant Formula Trials Which Support Breastfeeding - Outcomes of a Delphi Consensus Project, 5th International Clinical Trials Methodology Conference, Publisher: BMC
Khaleva E, Gridneva Z, Geddes DT, et al., 2019, Transforming growth factor beta in human milk and allergic outcomes in children: A systematic review, Clinical and Experimental Allergy, Vol: 49, Pages: 1201-1213, ISSN: 0954-7894
BACKGROUND: Human milk (HM) transforming growth factor beta (TGF-β) is critical for inflammation regulation and oral tolerance promotion. Previous reports suggested that variations in HM TGF-β levels are associated with allergic outcomes. OBJECTIVE: We undertook a systematic review (PROSPERO 2017 CRD42017069920) to reassess the evidence on the relationships between HM TGF-β and allergic outcomes in children. METHODS: Electronic bibliographic databases (MEDLINE, EMBASE, Cochrane Library) were systematically searched. Two independent reviewers screened reference lists, extracted the data and assessed risk of bias using the National Institute for Clinical Excellence methodological checklist. RESULTS: A total of 21 studies were identified. Sixteen studies assessed relationships between HM TGF-β and risk of eczema; 14, allergic sensitisation; 9, wheezing/asthma; 6, food allergy; 3, allergic rhinitis/conjunctivitis. Five cohorts (5/18, 28%) reported a protective effect of TGF-β1, while 3 (3/10, 30%) suggested increased risk of allergic outcomes development and 1 (1/10, 10%), a protective effect of TGF-β2 on eczema. Meta-analysis was not possible due to significant heterogeneity in methodology, age of outcome assessment and differing statistical approaches. 71% (15/21) of studies carried a high risk of bias. CONCLUSION AND CLINICAL RELEVANCE: In contrast with previous findings we did not find strong evidence of associations between HM TGF-β and allergic outcomes. Differences in studies' methodology and outcomes do not allow unconditional rejection or acceptance of the hypothesis that HM TGF-β influences the risk of allergy development. Future studies on diverse populations employing standardised methods, accurate phenotyping of outcomes and evaluation of the effect of TGF-β in combination with other HM immune markers, microbiome and oligosaccharides are required.
Cumming TB, Churilov L, Collier J, et al., 2019, Early mobilization and quality of life after stroke Findings from AVERT, NEUROLOGY, Vol: 93, Pages: E717-E728, ISSN: 0028-3878
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- Citations: 22
Garcia AO, Bartra J, Garcia RM, et al., 2019, Do threshold data from food challenges reflect real-life allergen exposure?, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), Publisher: WILEY, Pages: 151-151, ISSN: 0105-4538
Kelleher MM, Jay N, Perkin MR, et al., 2019, A novel approach to food allergy diagnosis within a primary prevention trial, Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI), Publisher: WILEY, Pages: 151-151, ISSN: 0105-4538
Burgess JA, Dharmage SC, Allen K, et al., 2019, Age at introduction to complementary solid food and food allergy and sensitization: a systematic review and meta-analysis, Clinical and Experimental Allergy, Vol: 49, Pages: 754-769, ISSN: 0954-7894
BACKGROUND AND OBJECTIVE: An infant's age at introduction of complementary solids may contribute to food allergy. We aimed to synthesize the literature on the association between age at introduction of complementary solids, excluding milk products, and food allergy and sensitization. DESIGN: We searched the electronic databases PubMed and EMBASE (January 1946-February 2017) using solid food, allergy and sensitization terms. METHODS: Two authors selected papers according to inclusion criteria, identifying 16 cohort studies, 1 case-control study and 8 randomized controlled trials (RCTs). Pooled effects across studies were estimated using random-effects meta-analysis. RESULTS: Cohort studies - Introducing complementary solids at age ≥4 months versus <4 months was not associated with food allergy (OR 1.22; 95%CI, 0.76-1.96) but was associated with food sensitization (OR 1.93; 95%CI 1.57-2.38). First exposure from age 4-6 months versus <4 months was not associated with food allergy (OR 1.01; 95%CI, 0.64-1.60) but was associated with food sensitization (OR 2.46; 95%CI 1.55-3.86). RCTs - Egg exposure from age 4 months was associated with reduced egg allergy (OR 0.63, 95%CI, 0.44-0.90) and sensitization (OR 0.76, 95%CI, 0.51-0.95). Peanut exposure from age 4 months compared to delayed exposure was associated with reduced peanut allergy (OR 0.28, 95%CI 0.14-0.57). CONCLUSIONS: We found no evidence from observational studies that introducing solids before 4 months protected against food allergy, but there was evidence for protection against food sensitization. From RCTs, introducing egg from 4-6 months and peanut from 4-11 months, reduced the risk of egg allergy, peanut allergy and egg sensitization. This article is protected by copyright. All rights reserved.
Presley C, Rundle CW, Kolodziejczyk T, et al., 2019, Prioritisation of Cochrane Skin Systematic Reviews., Br J Dermatol
Dear Editor, the Cochrane Collaboration is a not-for-profit organisation that provides relevant and accurate systematic reviews to guide medical practice. Cochrane's review methodology produces higher quality reviews, marking Cochrane as the gold standard in evidence synthesis.2 There has been an increase in the global production of systematic reviews in the last 15 years, with more than 8000 systematic reviews now published each year; however, reviews which lack methodological rigour or which address low priority questions result in conclusions which may be redundant, inaccurate, or lack impact. To ensure that Cochrane's resources and expertise are used for novel and important reviews, Cochrane Skin (CS) has developed a new prioritisation process that focuses on the timely production of high impact systematic reviews. This article is protected by copyright. All rights reserved.
Vickers B, Boyle RJ, Umasunthar T, et al., 2019, Therapy competence in delivering a brief cognitive behavioural therapy intervention to reduce maternal anxiety associated with child food allergy., J Child Health Care, Pages: 1367493519853436-1367493519853436
Child food allergy is increasingly prevalent, and caring for such children is associated with elevated parental anxiety. We previously carried out a randomized-controlled trial (RCT) of brief cognitive behavioural therapy (CBT) for parental anxiety associated with child food allergy which found that treatment to be effective. This study describes the manualized brief CBT intervention and assesses the acquisition of competence in delivering this therapy. Three healthcare professionals were trained and supervised in the delivery of brief CBT to 98 mothers of food-allergic children. Competency was assessed using the Revised Cognitive Therapy Scale (CTS-R), with 'competency' defined as a CTS-R score ≥3. All therapists' CTS-R scores increased over time. In the first four months, the mean (SD) CTS-R score was 2.31 (0.56), increasing to 3.14 (0.41) in the second four months ( p < .001). Overall, 13/19 (68%) of CBT sessions were rated with a CTS-R score ≥3 in the second four months. After eight months, all therapists were performing CBT at a competent level (17 of the 18 sessions or 94%). The therapists participated in a RCT that reduced maternal anxiety (reported elsewhere). We have shown that therapists not previously trained in CBT can be trained in specific interventions and reach competent levels quickly.
Ridd MJ, Edwards L, Santer M, et al., 2019, TEST (Trial of Eczema allergy Screening Tests): protocol for feasibility randomised controlled trial of allergy tests in children with eczema, including economic scoping and nested qualitative study, BMJ Open, Vol: 9, Pages: 1-10, ISSN: 2044-6055
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