Practical challenges in oral immunotherapy resolved through patient-centered care

Allergy, Asthma & Clinical Immunology

Philippe Bégin¹  François Graham¹  Douglas P. Mack² 

[1] Allergy and Immunology, Centre Hospitalier de L’Université de Montréal, Hôpital Notre-Dame, Montreal, QC, Canada;Allergy and Immunology, Centre Hospitalier Universitaire Sainte-Justine, 3175 Chemin de la Cote Sainte-Catherine, H3T1C5, Montréal, QC, Canada;Department of Pediatrics, McMaster University, Hamilton, ON, Canada;

关键词: Oral immunotherapy;    Food allergy;    Peanut allergy;    Multi-food oral immunotherapy;    Oral food challenge;    Shared decision-making;    Patient-centered care;   

DOI  :  10.1186/s13223-021-00533-6

来源: Springer

【 摘 要 】

Oral immunotherapy (OIT) is now widely recognized as a valid option for the management of IgE-mediated food allergies. However, in real-life practice, OIT can lead to a variety of unique situations where the best course of action is undetermined. In patient-centered care, individual patient preferences, needs and values, should guide all clinical decisions. This can be achieved by using shared-decision making and treatment customization to navigate areas of uncertainty in a way that is responsive to patient’s needs and preferences. However, in the context of OIT, lack of awareness of potential protocol adaptability or alternatives can become a barrier to treatment personalization. The purpose of this article is to review the theoretical bases of patient-centered care and shared decision-making and their practical implication for the patient-centered delivery of OIT. Clinical cases highlighting common challenges in real-life OIT practice are presented along with a discussion of potential personalized management options to be considered. While the practice of OIT is bound to evolve as additional scientific and experiential knowledge is gained, it should always remain rooted in the general principles of patient-centered care.

【 授权许可】

CC BY