Abstract Background Food allergy (FA) in children not only affects medical outcomes but also wellbeing, social activities, and family dynamics. Despite recent therapeutic advances, the psychosocial burden of FA remains poorly documented in France. Objectives To assess the social, emotional, and daily‐life consequences of FA in children and their parents, and to identify factors associated with an increased burden. Methods This multicentre cross‐sectional questionnaire study was conducted in four pediatric allergy departments in the Paris area. Children and parents completed shortened questionnaires adapted from previously used French versions of the multidimensional, study‐specific APPEAL survey instrument. These adapted versions were focused on emotional distress, social exclusion, and daily constraints related to FA. The questionnaires were delivered during day‐hospital visits. Clinical and demographic data were also collected, such as child's sex, age at inclusion, family structure, and presence of siblings. Medical data comprised personal or first‐degree family history of atopy, and presence of non‐atopic chronic diseases. FA‐related variables included allergen type, number of avoided foods, age at first FA diagnosis, number of allergic reactions, history of epinephrine use, and severity of the initial reaction. FA management data included multiple‐food elimination diet, possession of an emergency kit containing epinephrine, presence of an individualized action plan at school, requirement for a packed meal from home, permission to consume foods with precautionary allergen labeling, treatment with OIT and/or biologics, and participation in a FA educational programme. Results 250 families were included, representing 344 respondents (102 children and 242 parents). Children were mainly boys (62.8%), with a median age of 6 [3;10] years (mean 6 ± 4.48; min–max 0–17). Children frequently reported feeling different from others (88.2%) and frustrated (62.4%), while 34.4% reported feeling lonely because of their food allergy to some degree. Limitations in daily choices were common, particularly regarding social events (85.3%), and FA often required additional planning in daily life (81.3%) and for special activities (77.2%). Among parents, 85.5% reported daily stress related to their child's FA, and 78.5% reported frustration. Requirement for a packed meal from home, hen's egg allergy and cow's milk allergy were associated with greater burden in selected domains, according to univariate analyses with correction for multiple comparisons. Conclusion Children with FA and their families still experience a substantial psychosocial burden. These findings highlight the importance of integrating psychological support, adapted education, and increased societal awareness into comprehensive allergy management. image
Abstract Background Achieving and maintaining pediatric asthma control depends on effective and regular monitoring. While a wide range of monitoring tools are available, how and why clinicians use these in routine practice has not been formally characterized. Here we describe distinct real‐world monitoring patterns among healthcare professionals ( HCPs ) caring for children with asthma in an international convenience survey, examining the geographic, professional, and institutional factors associated with them. Methods Data from the international cross‐sectional Pediatric Asthma in Real Life ( PeARL ) HCP survey, administered to clinicians with expertise in childhood asthma, were analyzed. Monitoring patterns were derived by Ward agglomerative hierarchical clustering on four standardized domains: clinical evaluation, spirometry, fractional exhaled nitric oxide ( FeNO ), and home‐monitoring. Independent associations between cluster membership and region, specialty, sector, and level of care were estimated by multinomial logistic regression ( MLR ). Results 951 HCPs from 78 countries were included. Four monitoring patterns emerged: Low‐intensity ( n = 88, 9.3%), lower overall monitoring intensity but moderate clinical assessment; Clinical ( n = 449, 47.2%), predominantly clinical assessment with moderate spirometry but infrequent FeNO and home monitoring; Clinical & Objective ( n = 308, 32.4%) with additional regular spirometry with moderate FeNO use and Comprehensive ( n = 106, 11.1%), also providing home monitoring. In MLR ( n = 933), region and care level were significantly associated with cluster membership ( p < .001), and specialty ( p = .012) and sector ( p = .039) also contributed independently. The most pronounced gradients involved objective in‐clinic testing: specialists were 3.5‐fold (95% CI 1.68–7.37) more likely than generalists, and tertiary‐care HCPs 3.3‐fold (95% CI 1.99–5.58) more likely than primary‐care HCPs, to belong to the Clinical & Objective pattern, with routine use of objective measures concentrated in Western and Northern European practices. Home monitoring showed no consistent gradient across the measured characteristics. Conclusion Real‐world pediatric asthma monitoring follows recognizable patterns, distinguished by the use of objective in‐clinic testing and between‐visit home‐based practices. Nearly half of HCPs relied predominantly on clinical assessment with limited use of FeNO and home‐based monitoring, and only a minority integrated home‐monitoring tools. Objective in‐clinic testing concentrated in specialist services and Western/Northern European practices, while home‐monitoring adoption showed no consistent gradient. These findings identify factors associated with pediatric asthma monitoring and suggest system‐level factors that warrant direct evaluation in dedicated implementation studies. image
