THE PREVALENCE of food allergy in England has increased significantly, according to recent research, with most cases being managed in primary care and a concerningly low rate of adrenaline autoinjector prescriptions, especially among those with a history of anaphylaxis.
Researchers analysed data from the Clinical Practice Research Datalink (CPRD) between 1998 and 2018, with additional linkage to relevant hospital encounters. The analysis focused on the incidence and prevalence of food allergy, categorised into three definitions: possible food allergy, probable food allergy, and probable food allergy with an associated prescription for adrenaline autoinjectors. The study also examined the distribution of adrenaline autoinjector prescriptions by socio-economic status, age, and history of food anaphylaxis. Additionally, the study explored the settings in which patients with food allergies were treated, comparing general practice with emergency department visits.
The study included 7,627,607 individuals, of whom 150,018 had a possible food allergy. Of these, 121,706 met the criteria for probable food allergy, with 38,288 receiving prescriptions for adrenaline autoinjectors. The incidence of probable food allergy doubled between 2008 and 2018, from 75·8 individuals per 100 000 person-years (95% CI 73·7–77·9) in 2008 to 159·5 (156·6–162·3) individuals per 100 000 person-years in 2018, and there was an increase in prevalence from 0.4% to 1.1%. The highest prevalence was observed in children under five years of age, while lower prevalence rates were found in older children and adults. Notably, only 58.3% of individuals with a history of food anaphylaxis were prescribed adrenaline autoinjectors, with lower prescription rates among residents of more deprived areas. The majority of food allergy-related healthcare visits (97.1%) occurred in primary care settings.
In conclusion, the rising burden of food allergy in England, particularly among children, highlights the need for improved management strategies in primary care. The low rates of adrenaline autoinjector prescriptions among high-risk patients suggests that primary care providers require better support and resources to manage food allergies effectively and ensure that patients at risk of anaphylaxis receive appropriate care.
Katrina Thornber, EMJ
Reference
Turner PJ et al. Time trends in the epidemiology of food allergy in England: an observational analysis of Clinical Practice Research Datalink data. Lancet Public Health. 2024;9(9):e664-e673.
