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Immunology (including allergy)
Research
A national survey of Russian physicians' knowledge of diagnosis and management of food-induced anaphylaxis
  1. Daniel Munblit1,2,3,
  2. Marina Treneva3,4,
  3. Ilya Korsunskiy2,
  4. Alan Asmanov4,
  5. Alexander Pampura4,
  6. John O Warner1,3,5
  1. 1 Department of Paediatrics, Imperial College London, London, UK
  2. 2 Faculty of Pediatrics, I.M. Sechenov First Moscow State Medical University, Russia
  3. 3 International Inflammation (in-FLAME) Network of the World Universities Network, Perth, WA, Australia
  4. 4 Allergy Department, Veltischev Clinical Pediatric Research Institute of Pirogov Russian National Research Medical University, Russia
  5. 5 National Institute of Health Research Collaboration for Leadership in Applied Health Research and Care for NW London, London, UK
  1. Correspondence to Dr Daniel Munblit; daniel.munblit08{at}imperial.ac.uk

Abstract

Objectives Food allergy is an increasing burden worldwide and is a common problem within paediatric populations, affecting 5%–8% of children. Anaphylaxis caused by food proteins is a potentially life-threatening condition and all healthcare practitioners should be aware of its recognition and management. Russia is the largest country in Europe but it is still unknown whether physicians are prepared to diagnose and manage food-induced anaphylaxis effectively. We aimed to examine physicians’ knowledge of diagnosis and management of food-induced anaphylaxis.

Setting, population and outcomes A survey was designed and published online at VrachiRF.ru website (for registered Russian-speaking practicing physicians). We obtained information on respondents’ clinical settings, experience and specialty. Survey questions were based on a characteristic clinical scenario of anaphylaxis due to food ingestion. Outcome measures consisted of correct answers to the anaphylaxis diagnosis and management questions.

Results From a total of 707 of physicians accessed in the survey, 315 (45%) responded to the clinical scenario. 16 respondents reported training in allergy-immunology and have been excluded from the analysis, leaving the final sample size of 299. Respondents were paediatricians (68%) and other specialties adult physicians (32%). Overall, 100 (33%) of respondents diagnosed anaphylaxis, but only 29% of those making the correct diagnosis administered adrenalin (1:1000) intramuscular. Respondents working in secondary/tertiary clinics diagnosed anaphylaxis significantly more often (p=0.04) when compared with primary care/private practice physicians. This difference was also apparent as the most important influence on responses in the multivariate analysis.

Conclusions In this national sample of Russian physicians, we found poor knowledge in both anaphylaxis diagnosis and management. Our data show that the chance of being properly diagnosed with anaphylaxis is 33% and being appropriately treated with adrenalin is 10%. These findings highlight lack of anaphylaxis knowledge among Russian physicians, both paediatricians and other specialists and illustrates the urgent need for allergy/anaphylaxis training.

  • anaphylaxis
  • survey
  • food-induced anaphylaxis
  • anaphylaxis knowledge

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/

https://doi.org/10.1136/bmjopen-2017-015901

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    Footnotes

    • Contributors DM, MT, IK and JW designed a questionnaire. AA and AP provided an independent evaluation of the survey instrument and assisted with the presurvey pilot testing. DM and MT conceived the study, designed the methods and coordinated data collection. DM wrote the first draft of the paper. MT and JW contributed to the writing of the paper.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. However, JW is funded through the National Institute of Health Research (NIHR), Collaboration for Leadership in Applied Health Research and Care for NW London. The views expressed in the paper are those of the authors and are not necessarily those of the National Health Service, the NIHR or the Department of Health.

    • Competing interests None declared.

    • Ethics approval R&D office, Speransky Hospital, I.M. Sechenov First Moscow State Medical University, Moscow, Russia.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The Excel data set is available from corresponding author on request.