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Researchers try casual exposure to reduce children’s anxiety over nut allergies

Image of Scott Sicherer
Scott H. Sicherer

In a recent randomized control trial, researchers asked pediatric patients with nut allergies to casually touch the allergen, hoping it would reduce their anxiety about coming in contact with it. This approach did not reduce their anxiety any more than education did alone, but researchers stressed that casual exposure to allergens is a common worry among patients, and providers should discuss it.

Scott H. Sicherer, MD, professor of pediatrics and director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, suggested to Infectious Diseases in Children that these concerns stem from the misconception that patients could have a severe allergic reaction if they casually touch the allergen.

“Education about the risk of skin exposure is an option that may help people feel less worried,” he said. “When an allergen touches the skin, it may cause no symptoms or may cause a local itch or rash, but it is not likely to cause anything severe. Eating the allergen is the way a more severe reaction could happen.”

In the TOUCH study, Sicherer and colleagues enrolled patients between the ages of 9 and 17.5 years with peanut or tree nut allergy who had expressed concern about casual exposure to their allergen. The patients were then randomly assigned to receive education about casual exposure alone (n = 30) or education plus touching their allergen (n = 30).

The researchers observed that patient worry before and immediately after the intervention was comparable among those who received education only and those who received education and touched their allergen (P = .12). Rather, both groups experienced a significant decrease in patient- and parent-reported worry of exposure (P < .001).

Additionally, both groups reported significant improvements in quality of life 1 month after the intervention was administered, but touching the allergen was not superior to education alone.

“Our findings suggest that explaining the risk of casual skin exposure and just talking about it actually goes quite far in making people less worried,” he said. “With just a minute or 2 of education, you can help people who would otherwise be worried about this.” – by Katherine Bortz

Reference: Weinberger T, et al. A randomized control trial to reduce food allergy anxiety about casual exposure by holding the allergen: TOUCH Study. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.

Disclosure: Sicherer reports no relevant financial disclosures.

Image of Scott Sicherer
Scott H. Sicherer

In a recent randomized control trial, researchers asked pediatric patients with nut allergies to casually touch the allergen, hoping it would reduce their anxiety about coming in contact with it. This approach did not reduce their anxiety any more than education did alone, but researchers stressed that casual exposure to allergens is a common worry among patients, and providers should discuss it.

Scott H. Sicherer, MD, professor of pediatrics and director of the Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, suggested to Infectious Diseases in Children that these concerns stem from the misconception that patients could have a severe allergic reaction if they casually touch the allergen.

“Education about the risk of skin exposure is an option that may help people feel less worried,” he said. “When an allergen touches the skin, it may cause no symptoms or may cause a local itch or rash, but it is not likely to cause anything severe. Eating the allergen is the way a more severe reaction could happen.”

In the TOUCH study, Sicherer and colleagues enrolled patients between the ages of 9 and 17.5 years with peanut or tree nut allergy who had expressed concern about casual exposure to their allergen. The patients were then randomly assigned to receive education about casual exposure alone (n = 30) or education plus touching their allergen (n = 30).

The researchers observed that patient worry before and immediately after the intervention was comparable among those who received education only and those who received education and touched their allergen (P = .12). Rather, both groups experienced a significant decrease in patient- and parent-reported worry of exposure (P < .001).

Additionally, both groups reported significant improvements in quality of life 1 month after the intervention was administered, but touching the allergen was not superior to education alone.

“Our findings suggest that explaining the risk of casual skin exposure and just talking about it actually goes quite far in making people less worried,” he said. “With just a minute or 2 of education, you can help people who would otherwise be worried about this.” – by Katherine Bortz

Reference: Weinberger T, et al. A randomized control trial to reduce food allergy anxiety about casual exposure by holding the allergen: TOUCH Study. Presented at: American Academy of Allergy, Asthma and Immunology Annual Scientific Meeting; Feb. 22-25, 2019; San Francisco.

Disclosure: Sicherer reports no relevant financial disclosures.

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