Eight tips for the implementation of the first licenced peanut allergy oral immunotherapy into clinical practice

• Type of Material: Article
• Authors: Jay Portnoy, Children's Mercy Hospitals and Clinics; Christina E Ciaccio, The University of Chicago; Janet Beausoleil, The Children's Hospital of Philadelphia; George Du Toit, King’s College London, London; Stanley Fineman, Emory University; Stanley A Tilles, Aimmune Therapeutics; June Zhang, Latitude Food Allergy Care; Claire Lawrence, Acaster Lloyd Consulting Ltd; Mohamed Yassine, Aimmune Therapeutics; Shahzad S Mustafa, University of Rochester School of Medicine and Dentistry
• Language: English
• Date: 2022-12-01
• Publisher: Springer Nature
• Publication Version: Final Published Version
• Copyright Statement: © The Author(s) 2022
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1186/s13223-022-00671-5
• Title of Journal or Parent Work: Allergy, Asthma and Clinical Immunology
• Volume: 18
• Issue: 1
• Start Page: 37
• End Page: 37
• Grant/Funding Information: This research was sponsored by Aimmune Therapeutics, a Nestlé Health Science company.
• Keywords: Adherence; Shared decision making; Implementation; Oral immunotherapy; Peanut oral immunotherapy; Desensitization; Allergy immunotherapy; Food allergy treatment; Peanut allergy; Education
• Research Categories: Health Sciences, Immunology; Health Sciences, Medicine and Surgery

Abstract

Background: Shared learnings from the early use of novel therapies can aid in their optimization. The recent introduction of peanut oral immunotherapy (peanut OIT; Palforzia [Peanut (Arachis hypogaea) Allergen Powder-dnfp]) for peanut allergy addresses a significant unmet need but also highlights the requirement for consideration of several factors by both prescribers and patients. Objective: To provide guidance for prescribers of licenced peanut OIT to facilitate treatment delivery and improve outcomes. Methods: Clinicians with experience of licenced peanut OIT (United States n = 6, United Kingdom n = 1) participated in a series of interviews and group discussions designed to elicit tips for successful implementation. Results: Clinicians identified 8 tips that were considered the most relevant, practical, and impactful for prescribers of Peanut (Arachis hypogaea) Allergen Powder-dnfp: (1) preparing to provide treatment, (2) assessing the medical indication for treatment and (3) shared decision making, (4) staff education, (5) establishing office processes, (6) managing patient expectations and using anticipatory guidance, (7) optimising adherence and (8) maintaining flexibility throughout the treatment process. In addition, a range of supporting materials (e.g., checklists and action plans) are provided. Conclusion: The introduction of a novel therapy often requires healthcare providers to modify or adopt practices to effectively employ the treatment. The provision of guidance based upon early real-world experiences of licenced peanut OIT may help inform clinical practice and improve treatment outcomes.