Over the last several years, Stanford food allergy expert Kari Nadeau, MD, PhD, and her team have demonstrated that oral immunotherapy allows patients to build tolerance to their food allergy triggers. The treatment, once completed, can be life-changing. Instead of carefully avoiding trace amounts of foods such as peanuts or milk, patients can finally eat at restaurants, grocery shop and take part in social activities without worry.
But the treatment itself can make patients and their families quite anxious. So a team of Stanford psychologists collaborated with Nadeau to see if they could help patients reframe their view of the treatment's side effects to lower their anxiety. Their findings appear today in the Journal of Allergy and Clinical Immunology: In Practice.
Why the anxiety? Oral immunotherapy requires that patients consume tiny, gradually increasing doses of their food-allergy triggers. This can produce side effects like an itchy mouth or congestion — signs patients have previously interpreted as the beginning of a dangerous allergic reaction. In a Stanford press release, Nadeau explained:
I’ve seen firsthand how challenging this treatment can be for patients and their families to complete. Experiencing symptoms during treatment can be a source of anxiety that can lead patients to end treatment early, so we were particularly eager to find a mindset that could help patients come to understand symptoms in a more adaptive way.
In the new study, led by postdoctoral scholar Lauren Howe, PhD, of the Stanford Mind & Body Lab, the research team recruited 50 children receiving oral immunotherapy and split them in two groups. Half the children and their parents received standard information about handling mild side effects, such as how to treat them with antihistamine medications. The other group got the standard information, but also was encouraged to view mild, non-life-threatening side effects as signs that the treatment was working. At the end of the trial, patients and families in the positive-mindset group reported significantly less worry during the treatment process.
Again, from the press release:
'We have shown that a simple change in the way we frame and discuss side effects of a treatment can have a meaningful impact not only on anxiety and adherence but also on the physiological benefits of that treatment,' said Alia Crum, PhD, the principal investigator at the Stanford Mind & Body Lab and senior author of the paper.
Photo by Porapak Apichodilok