Tuesday, September 13, 2016
Influence of Regional and National Guidelines on Prescriptions for Cow’s Milk Allergy
Infant Feeding Guidelines were developed by Health and Social Care Board in April 2013 in Northern Ireland to facilitate primary care health professionals to differentiate milk allergies occurring during the 1st year of life. The national Milk Allergy in Primary care guidelines provided a practical summary for the United Kingdom primary care on diagnosis and management of cow’s milk allergy (CMA). A study published in the Journal of Pediatric Gastroenterology and Nutrition assessed the impact of these infant feeding guidelines on prescribing patterns for CMA in children, using a simple and inexpensive training package for primary health care professionals.
Data on prescription patterns of infant feeding products were prospectively collected and retrospectively analysed. Data on prescriptions for hypoallergenic formulae such as amino acid-based formulae and extensively hydrolysed formulae appropriate for CMA were compared with alternative prescriptions such as antiregurgitation and anticolic products, lactose-free and partially hydrolysed milks, or infant Gaviscon that are inappropriately prescribed for CMA.
Training primary care health professionals in CMA management increased the total quantity of hypoallergenic formulae prescriptions appropriate for CMA by 63.2% while the quantity of alternative prescriptions inappropriately prescribed for CMA decreased by 44.6%. A decrease of 41.0% in the total quantity of all prescribed products was observed. Overall, the proportion of recommended hypoallergenic formulae increased from 3.4% (before intervention) to 9.8% in the short- and long-term follow-up periods.
Training primary health care professionals on infant feeding guidelines effectively increased the number of prescriptions appropriate for CMA while reducing alternative prescriptions inappropriately prescribed for CMA. Future research should focus on the cost-effectiveness and socioeconomic impact of such training.
News source - Wauters L, Brown T, Venter C, et al. Cow's Milk Allergy Prescribing Is Influenced by Regional and National Guidance. J Pediatr Gastroenterol Nutr. 2016; 62(5):765–70.