Mobile/web application for monitoring food oral immunotherapy in children (Preprint)

Abstract

Milk and egg allergy have a significant impact on patients quality of life especially in children. Food oral immunotherapy (OIT) has emerged as an effective treatment option, but frequent adverse reactions can be challenging requiring a close monitorization during treatment.

This study aimed to evaluate the ability of a new mobile/web application called OITcontrol® in monitoring milk and egg OIT.

Patients undergoing milk or egg OIT were recruited and divided into two groups: the active group used the OITcontrol® app in addition to standard written monitoring methods, while the control group used only written diaries. Investigators recorded hospital doses, hospital reactions and administered treatment on the website. Patients recorded daily allergen home-doses intake, home reactions and administered treatment using the app. The following variables were compared between both groups: number and severity of hospital and reported home reactions, patient´s adhesion to OITcontrol® app and/or written diary in terms of daily home-dose intake and home reactions recording, as well as treatment and dose adjustment compliance at home in case of reaction.

Sixteen patients were assigned to be monitored by the app OITcontrol® and additional written methods (actives) and 14 patients only by a written paper diary (controls). Similar distribution was observed regarding sex, age, basal characteristics, allergen treated in OIT, premedication and sensitization profile. Active patients reported a similar number of hospital and home reactions compared to the control group. Regarding recording system use, 81.3% of active patients used OITcontrol® application while 71.4% of control patients used the written diary; 37.5% of active patients used both methods and one active patient used only written methods. However, control patients recorded more frequently home reactions than active patients (P=.009). Among active patients the app (68.6%) was preferentially used to record reactions (P<.001) rather than written diary (17.4%) or both methods (14%). Treatment compliance in home recorded reactions was similar between both groups (P=.148). However, treatment indications after an adverse reaction were more frequently followed (P=.039) in reactions recorded only in the app (61%); than in written diary (40.8%) or both systems (33.2%). Moreover, dose adjustment compliance after a moderate-severe reaction in home recorded reactions was higher in active than in control group (P<.001). Home reactions recorded only in the app (84.2%) followed dose adjustment more frequently (P<.001), than those recorded in written diary (15%) or in both methods (66.7%).

OITcontrol® app may be a helpful tool to monitor OIT treatment in children with food allergy. It is a suitable method to record daily home dose intakes and reactions and seems to improve treatment indications after an adverse reaction and dose adjustment compliance in home reactions. However, further studies are needed to fully understand the benefits and limitations of using OITcontrol® app in OIT management.