Suspected cow's milk allergy in everyday general practice: A retrospective cohort study on health care burden and guideline adherence

被引：9

作者：

Van Den Hoogen S.C.T.A. ^{[1
]}

Van De Pol A.C. ^{[1
]}

Meijer Y. ^{[2
]}

Toet J. ^{[3
]}

Van Klei C. ^{[4
]}

De Wit N.J. ^{[1
]}

机构：

[1] Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Str 6.131 Postbus 85500, Utrecht, GA

[2] Department of Paediatric Pulmonology and Allergology, University Medical Center Utrecht, Utrecht AB

[3] Department of Health Promotion and Epidemiology, Municipal Health Services Utrecht, Utrecht AN

[4] Preventive Child Health Care, Municipal Health Services Utrecht, Utrecht AN

来源：

BMC Research Notes | / 7卷 / 1期

关键词：

Diagnostic; Food hypersensitivity; Guideline adherence; Prevalence; Primary care;

D O I：

10.1186/1756-0500-7-507

中图分类号：

学科分类号：

摘要：

Background: Cow's milk allergy (CMA) is the most common food allergy among infants. No data are available on the health care burden of suspected CMA in general practice. This study was conducted to evaluate the burden of suspected CMA in general practice (GP): (a) prevalence, (b) presenting symptoms, (c) diagnostic process, (d) guideline adherence, and (e) dietary measures. Methods. A retrospective cohort study was carried out in four Julius Healthcare Centers (JHCs). These JHCs form the core primary care academic network of the department of general practice of the University Medical Center of Utrecht. Electronic records of the first year of infants born May 2009 - April 2010 registered in the JHCs were screened for possible CMA suspicion. Preventive child healthcare (PCH) records were reviewed for additional information. Clinical presentation, diagnostic strategies and dietary measures were extracted. Results: Of 804 infants evaluated, 55 presented with symptoms fitting the suspicion of CMA (prevalence of 7%). Presenting complaints involved the skin (71%); the gastrointestinal tract (60%); the respiratory tract (13%) or other symptoms (36%) and 23 infants presented with symptoms of two or more organ systems. In 31 children (56%) a food challenge was performed (n = 28 open and n = 3 double-blind). Open challenge test results were difficult to interpret due to inadequate implementation or reporting. None had confirmed CMA after an adequate challenge test. Long term milk substitute formulas were prescribed in 39 (71%) infants. Conclusion: On a yearly basis seven percent of children visit their GP for suspected CMA. A positive CMA diagnosis was rarely established after adequate implementation and reporting of diagnostics, yet long term dietary measures were prescribed in >70% of patients. There is definitely need for improvement of diagnosing CMA in primary care. © 2014 van den Hoogen et al.; licensee BioMed Central Ltd.

引用

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