BackgroundThe transition to adulthood can be particularly challenging for young people with severe allergies, who must learn to balance personal safety with independent living. Information and support for young people and their families are crucial to successfully managing this transition. We sought to: gather insights into the impact of severe allergies on the lives of young people; explore where young people go for information about anaphylaxis and what information they want and need; identify areas where further support is needed.MethodsAn online questionnaire survey of young people aged 15–25 years with severe allergies in the United Kingdom (UK) was conducted on behalf of the Anaphylaxis Campaign, the main patient support organisation. Participants were recruited mainly from the Anaphylaxis Campaign membership database and also via allergy clinics and social media. The study was funded by the Anaphylaxis Campaign’s In Memoriam Fund.ResultsA total of 520 young people responded to the survey. The majority had lived with severe allergies since they were young children; 59% reported having attended Accident and Emergency units as a consequence of their allergies. Only 66% of respondents reported always carrying their epinephrine auto-injectors; only 23% had ever used these. Few were currently receiving specialist allergy care; younger respondents were more likely to be under specialist care (34%) than those 18 years and above (23%). Respondents wanted more information about eating out (56%), travelling (54%) and food labelling (43%). Almost a quarter of respondents (23%) reported needing more information on managing their allergies independently without parental help. Managing allergies in the context of social relationships was a concern for 22% of respondents.ConclusionsThis survey has identified the information and support needs and gaps in service provision for young people with severe allergies. Healthcare professionals and patient support organisations, with the support of the food industry, can help to meet these needs.

We present the first national care pathway for anaphylaxis, which is based on a critique of published evidence, expert consensus and multi-stakeholder input including patient representation via the Anaphylaxis Campaign. The Project Board urges health professionals to work together across networks to improve care for children at risk of anaphylaxis, in particular during the period after an acute reaction. Additionally, the Project Board strongly recommends the funding of a national anaphylaxis register.

The range of manifestations of food allergy/intolerance is much more diverse than hitherto recognised and diagnosis can be problematic as many patients do not have classical IgE mediated disease. The pathway provides a guide for training and development of services to facilitate improvements in delivery as close to the patient's home as possible. The authors recommend that this pathway is implemented locally by a multidisciplinary team with a focus on creating networks.

AimsThe Royal College of Paediatrics and Child Health has been commissioned by the Department of Health to develop national care pathways for children with allergies. The aim of the current project was to develop a national care pathway for children with anaphylaxis. The pathway focuses on standardising the level of care received by children with allergic conditions and defining the competences required to provide a high-quality service.MethodThe pathway was developed by the consensus of a multidisciplinary working group based on a systematic review of evidence from the Cochrane Library, Medline, the National Guidelines Clearing House, the Scottish Intercollegiate Network and the National Institute for Clinical Excellence. The pathway was then reviewed by a broad group of stakeholders including the public.ResultsThe results are presented in three sections: a pathway algorithm, the competences required to deliver the pathway and evidence-based recommendations. The principal points of pathway entry are defined and the ideal pathway of care is described in discrete stages from self-care through to follow-up.For each stage of the pathway, competences in the three main categories were identified: ▸ the things a health professional should know▸ the specific skills expected of a health professional▸ the services or facilities to which the health professional should have access. The review of the evidence in relation to children with anaphylaxis identified four key evidence-based recommendations.ConclusionThe authors have produced a national care pathway for anaphylaxis based on an evidence review, expert consensus and stakeholder input. The authors recommend that this pathway is implemented locally by multidisciplinary care teams with a focus on creating networks between primary, secondary and tertiary care to improve services for children with allergic conditions. The intention is that the use of this tool together with audit to ensure continuous improvement in the national delivery of services for children with anaphylaxis.

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