The role of dietitians and psychologists to promote optimum patient related outcomes in oral immunotherapy.

Abstract

Although research in oral immunotherapy for food allergy is perceived primarily as a biomedical endeavor, the involvement of multiple disciplines is required to ensure optimum outcomes for patients and their caregivers. This is a narrative review of research in which we also provide expert opinion due to the small number of studies addressing the role of dietitians and psychologists in oral immunotherapy to foods. Dietitians support patient education with instructions on how to measure and prepare the immunotherapy dose, incorporate the dose into the daily diet, and transition to equivalent foods to meet dosing needs. Dietitians play an important role in assessing the impact of oral immunotherapy on nutritional health. Psychological distress in food allergy is largely driven by the persistent fear of an adverse reaction, therefore the principal objective of food allergy treatment is to improve patient outcomes, e.g., quality of life. Psychologists must be involved in the design of patient related outcome measures in clinical trials to inform clinical decision-making and health-care policy; an important step in selecting and supporting patients who will benefit most from a particular treatment. Psychologists and dietitians can play a critical role during all phases of oral immunotherapy to foods.