Time trends in the epidemiology of food allergy in England: an observational analysis of Clinical Practice Research Datalink data.
Lancet Public Health
; 9(9): e664-e673, 2024 Sep.
Article
en En
| MEDLINE
| ID: mdl-39214635
ABSTRACT
BACKGROUND:
Estimates for the prevalence of food allergy vary widely, with a paucity of data for adults. The aim of this analysis was to report trends in the incidence and prevalence of food allergy in England, using a national primary care dataset.METHODS:
We analysed data from Clinical Practice Research Datalink between 1998 and 2018, with linked data to relevant hospital encounters in England. The main outcomes were incidence and prevalence of food allergy, according to three definitions of food allergy possible food allergy, probable food allergy, and probable food allergy with adrenaline autoinjectors prescription. We also evaluated the difference in proportion of patients prescribed adrenaline autoinjectors by English Index of Multiple Deprivation (IMD), age, and by previous food anaphylaxis, and explored differences in patient encounters (general practice vs emergency department setting).FINDINGS:
7â627â607 individuals in the dataset were eligible for inclusion, of whom 150â018 (median age 19 years [IQR 4-34]; 82â614 [55·1%] female and 67â404 [44·9%] male) had a possible food allergy. 121â706 met diagnostic criteria for probable food allergy, of whom 38â288 were prescribed adrenaline autoinjectors. Estimated incidence of probable food allergy doubled between 2008 and 2018, from 75·8 individuals per 100â000 person-years (95% CI 73·7-77·9) in 2008 to 159·5 (156·6-162·3) individuals per 100â000 person-years in 2018. Prevalence increased from 0·4% (23â399 of 6â432â383) to 1·1% (82â262 of 7â627 607) over the same period and was highest in children under 5 years (11â951 [4·0%] of 296â406 in 2018) with lower prevalence in school-aged children (from 11â353 [2·4%] of 473â597âin 2018 for children aged 5-9 years to 6896 [1·7%] of 404â525 for those aged 15-19 years) and adults (42â848 [0·7%] of 5â992â454âin 2018). In those with previous food anaphylaxis, only 2321 (58·3%) of 3980 (975 [64·0%] of 1524 children and young people and 1346 [54·8%] of 2456 adults) had a prescription for adrenaline autoinjector. Adrenaline autoinjectors prescription was less common in those resident in more deprived areas (according to IMD). In the analysis of health-care encounters, 488â604 (97·1%) of 503â198 visits recorded for food allergy occurred in primary care, with 115â655 (88·4%) of 130â832 patients managed exclusively in primary care.INTERPRETATION:
These estimates indicate an important and increasing burden of food allergy in England. Our findings that most patients with food allergy are managed outside the hospital system, with low rates of adrenaline autoinjector prescription in those with previous anaphylaxis, highlight a need to better support those working in primary care to ensure optimal management of patients with food allergy.FUNDING:
UK Food Standards Agency and UK Medical Research Council.
Texto completo:
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Banco de datos:
MEDLINE
Asunto principal:
Epinefrina
/
Hipersensibilidad a los Alimentos
Límite:
Adolescent
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Adult
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Child
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Child, preschool
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Female
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Humans
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Male
País/Región como asunto:
Europa
Idioma:
En
Año:
2024
Tipo del documento:
Article