Transforming Outcomes for Paediatric allergy In Primary care – The TOPIC programme

Conference:

SAPC ASM 2024 - Bristol

Talk Code:

5E.6

Presenter:

Andrew Turner

Twitter:

@ATurner0

Co-authors:

Andrew Turner, Raquel Granell, Phuong Hua, Alyson Huntley, Roxanne Parslow, Catriona Rutter, Matthew Ridd

Author institutions:

Centre for Applied Excellence in Skin and Allergy Research (CAESAR) Centre for Academic Primary Care University of Bristol

Problem

Eczema and food allergy are distinct but related problems. Eczema is a risk factor for food allergy, and having eczema and food allergy is doubly burdensome. However, not everyone with eczema has a food allergy and vice versa. There has been more primary care-relevant research done in eczema but important questions remain unanswered. Applied food allergy research is more limited and priorities are unclear.

Approach

TOPIC is an ambitious programme of work that will transform the treatment of eczema, and research into food allergy and its prevention, in children by:1. a) Conducting a systematic review, surveys and interviews to improve understanding of real-world use of topical treatments; and b) Co-designing a trial of how best to use emollients and topical corticosteroids (TCS) in combination.2. a) Developing a primary care eczema clinic; and b) evaluating it in a cluster trial.3. a) Determining the research priorities of parents and clinicians for food allergy in children, and b) delivering at least one study addressing at least one of the identified research priorities.4. Conducting surveys, interviews and establishing a cohort study to assess understanding, implementation and effects of early allergen introduction advice.5. Integrating public, patient (parent/child) and stakeholder opinion into all of the above, ensuring inclusivity and relevance of the research to all of society.

Findings

TOPIC will address the following questions:• What are the most effective and safe ways to use emollient and topical corticosteroids individually and/or in combination to treat children with eczema?• Does an eczema clinic in primary care improve disease control in children?• What are parents' and clinicians' priorities for food allergy research in children?• What awareness is there of early allergen introduction advice, is it being followed and is it preventing food allergy?

Consequences

The findings will improve the experience of care and outcomes for affected children and their families; and may reduce demand for appointments in primary and secondary care, with attendant cost savings. In addition, findings may improve the developmental and nutritional outlook of children, by improving eczema control and preventing/discouraging unnecessary dietary restrictions.

Submitted by:

Andrew Turner

Funding acknowledgement:

This project is funded by the NIHR Research Professorships scheme [Professor Matthew Ridd - NIHR303123]. The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.