Food Allergy & Anaphylaxis

Navigating

Navigating the Food Allergy Treatment Decision Process

Considering or deciding to pursue management of a food allergy is a major decision that may result in mixed emotions. Therefore, this informational handout aims to offer guidance on navigating the exploration process and psychological considerations associated with food allergy treatments.


Food Allergy Treatments Available

The cornerstone of management remains strict allergen avoidance and treatment of accidental ingestions with epinephrine. However, people are choosing to explore food allergy treatments in order to build tolerance that may protect against a reaction in case of accidental allergen exposure. These treatments are not cures, but aim to offer desensitization through carefully controlled ongoing allergen exposure. Additionally, there are risks and benefits with all treatments.

The following are food allergy treatments currently being offered or researched via clinical trials. (Refer to the American College of Allergy, Asthma and Immunology for more information)

• Oral Immunotherapy (OIT) - Ingestion of increasing amounts of allergen orally.

• Epicutaneous Immunotherapy (EPIT) - Ingestion of allergen via patch placed on the skin.


Consider the Following When Exploring Food Allergy Treatments

• Explore Motivations: Explore your and your child’s motivations for undergoing treatment. While the reasons may differ, it’s important to continually assess everyone’s motivation throughout treatment, as they may change and impact commitment levels.

• Determine Commitment: Assess your and your child’s level of commitment, as this may help determine if treatment is a good fit, and even when to begin treatment. All food allergy therapies require significant commitment.

• Assess Anxiety or Fear: Assess anxiety prior to starting treatment. While experiencing anxiety and worry is normal before and during treatment, excessive anxiety prior to the onset may be a factor in deciding when to begin a treatment.

• Evaluate Confidence in Provider: Ask questions that will help determine your level of comfort and confidence in the board-certified allergist administering the treatment.


Evaluation Process Before Beginning Treatment

Before enrolling in a food allergy treatment, it’s important to gather enough information to help not only make the decision whether or not to pursue it, but also to evaluate the board-certified allergist providing the treatment. Below is a question guide to help navigate this evaluation process.

Treatment & Provider Information: 
• What are the goals, expected outcomes, and specific protocols for treatment? 
• Are oral food challenges required to confirm the allergy before starting treatment? 
• Are oral food challenges required to determine effectiveness of the trearment? 
• What is the follow-up or maintenance protocol after treatment? 
• What is required of you/your child (i.e. appointment frequency, daily protocols)? 
• Will treatment impact school, work, activities, or daily routines, and if so, how? 
• How are viruses or illnesses navigated while taking part in the treatment? 
• How does the provider address treatment-related anxiety that may arise? 
• How familiar is the provider with the treatment?

Potential Benefits & Risks of Treatment: 
• What are the potential risks and benefits of the treatment, medical or otherwise? 
• Are anaphylactic reactions a potential risk of treatment? 
• What are potential treatment setbacks, their likelihood, and how they are handled?

Office Procedures: 
• Will appointments be with the provider, or associates within the practice? 
• Is a provider on call 24 hours/day in case of emergencies?


Develop A Flexible Food Allergy Treatment Mindset

Experiencing rigid thoughts and actions is natural when faced with uncertainty, discomfort, and distress. However, flexibility, or the ability to adapt, is beneficial when navigating treatments.

The following tips can help establish a flexible mindset and approach to food allergy treatments: 
• Establish open communication with your board-certified allergist and treatment team. 
• Engage in shared decision-making to develop treatment timeline and goals. 
• Understand that treatment is a process rather than just a desired outcome. 
• Prepare for the possibility of setbacks, the need to alter approaches, or stop treatment 
• Monitor anxiety levels, reaching out for counseling or support services if excessive.


Download FAACT's Navigating the Food Allergy Treatment Decision Process poster here.