Knowledge, Attitude and Practices of General Practitioners and Homeopaths Regarding Food Allergy and Anaphylaxis in India- A Comparitive Study

Abstract

Food allergy (FA) is a growing health problem in India and worldwide with notable prevalence in infants when compared with children and adults. Multiple genetic and nutritional factors play an important role in etiology of FA leading to morbidity and mortality. As general practitioners (GPs) and homeopaths are the first persons to be approached by patients with possible FA, the need for evaluating their Knowledge, Attitude and Practices (KAP) towards the same are essential to be studied.A total of 214 participants-107 GPs with or without specialization in Internal Medicine and 107 homeopaths participated in the study. A validated questionnaire was adopted to assess their KAP. The questionnaire had 31 parameters (demographic details-5, knowledge-21 and attitude and practices-5) regarding symptoms, severity, risk factors, diagnosis and treatment of FA. The score was recorded and results with p-value ≤0.05 were considered statistically significant.A significant difference in the perception of FA was observed between GPs (42.1%) and homeopaths (10.3%) regarding the safety of administering influenza vaccines in children with egg allergy (p=0.003). 80.4% of GPs and 23.3% homeopaths st believed that epinephrine is the 1 line choice for treatment of anaphylaxis (p=0.035). 64.5% GPs and 28.1% homeopaths opined that timely administration of epinephrine prevents fatal anaphylaxis which was statistically significant. (p=0.046). However no statistically significant difference (p=0.112) was found between GPs (65.4%) and homeopaths (58.9%) in their opinion regarding the reliability of positive skin prick test or radioallergosorbent test (RAST) as sufficient FA diagnostic tool. The total scores obtained regarding the knowledge in FA and anaphylaxis by GPs and homeopaths was 66.4% and 46.8% respectively which was not found to be statistically significant (p=0.172).Overall knowledge of FA in GPs and homeopaths was comparable with strengths and weakness in each domain. GPs had more precise knowledge than homeopaths, regarding the treatment schedule, in case of anaphylaxis, which in turn reflects the differences in attitude and approach in treating FA among the two groups. Periodic educational programs focused at improving the knowledge regarding food allergy and treatment options is a prerequisite among GPs and homeopaths help them to understand better as well as treat the adverse effects of FA.