Background: Patient quality of life (QOL) improves following successful completion of oral immunotherapy (OIT) but the process itself might have un-desirable effects.
Objectives: To evaluate QOL of patients following OIT induction and during treatment.
Methods: The Hebrew version of the Food Allergy Quality of Life Questionnaire (FAQLQ-PF) was validated and administered to parents of food-allergic children, aged 0-12 years, following OIT induction week (n=119) and after 5 months of treatment (n=90). Patient clinical history, course of induction week and adverse reactions during treatment were reviewed.
Results: Worse total FAQLQ-PF scores after induction week were associated with pre-OIT emergency room referrals and a lower maximal tolerated dose on induction on multi-variate analysis (p=0.005 and p=0.016, respectively). A moderate-strong negative correlation was found, in children aged 6-12 years, between the maximal tolerated dose and total FAQLQ-PF score (r=-0.41, p=0.001). Patients with improved (n=32), unchanged (n=39) and diminished (n=19) FAQLQ-PF total score after 5 months of treatment did not differ in pre-OIT clinical histories, tolerated dose at treatment induction, course of treatment or stage of treatment. Patients with improved FAQLQ-PF had a significantly diminished total score at baseline (4.36+/-1.1) compared to those with unchanged score (3.56+/-1.4, p=0.015) and decreased score (2.75+/-1.7, p<0.001).
Conclusions: Worse QOL following OIT induction is associated with a lower maximal tolerated dose, particularly in 6-12 year-old children. QOL during treatment improves in patients with worse baseline QOL. QOL diminishes in patients whose QOL at baseline is minimally affected, an effect that might be prevented by better patient preparedness towards initiation of treatment.
