Food allergy diagnosis and management practices among pediatricians

Clin Pediatr (Phila). 2014 Jun;53(6):524-30. doi: 10.1177/0009922813518425. Epub 2014 Jan 13.


Our goals were to (1) estimate the rates of parent-reported versus physician-diagnosed food allergy, (2) determine pediatrician adherence to national guidelines, and (3) obtain pediatricians' perspectives on guideline nonadherence. A mixed method approach was used, including survey, chart review, and qualitative methods. Overall, 10.9% of parents reported having a child with food allergy and two thirds of these cases were detected by the pediatrician. Chart reviews revealed high rates of guideline adherence with respect to allergist referral (67.3%), but less consistent adherence regarding documentation of reaction history (38.8%), appropriate use of diagnostic tests (34.7%), prescription of epinephrine autoinjectors (44.9%), and counseling families in food allergy management (24.5%). Pediatricians suggested that poor adherence was due to lack of documentation, familiarity with guidelines, and clarity regarding the pediatrician's role in managing food allergy. Findings emphasize the need to better establish the role of the pediatrician and to improve awareness and adherence to guidelines.

Keywords: food allergy; guidelines; management; pediatrics; primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Counseling
  • Epinephrine / administration & dosage
  • Female
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / therapy*
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Infant
  • Male
  • Pediatrics / standards*
  • Physician's Role
  • Practice Guidelines as Topic
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Primary Health Care


  • Epinephrine