D1.191 - Global Survey on Healthcare Provider Practices in the Primary Prevention of Food Allergy: Implementation and Regional Gaps

Despite the establishment of food allergy prevention guidelines in many countries, their implementation by healthcare professionals globally remains inconsistent. This study aimed to identify real-world application of these guidelines and regional disparities in preventive practices.

An anonymous online survey was distributed to healthcare providers across multiple countries through the World Allergy Organization network, collecting data on food allergy prevention recommendations in daily clinical practice.

The study included 571 healthcare providers from six continents: Asia (46.2%), Europe (27.7%), North America (13.0%), South America (7.9%), Africa (4.0%), and Oceania (1.2%). More allergy specialists provided prevention recommendations routinely (67%) than non-allergy specialists (43%) (p < .001). For infants without risk factors, allergy specialists recommended exclusive breastfeeding for 6 months (p < .001) and early solid food introduction (4-6 months) (p < .001) more frequently than non-allergy specialists. For high-risk infants, allergy specialists additionally recommended anti-inflammatory treatments for eczema more frequently than non-allergists (p < .001). For high-risk infants, allergy specialists recommended earlier introduction of all allergenic solids compared to non-allergy specialists (p < .05). For low-risk infants, allergy specialists recommended earlier introduction of most allergenic solids, except for soy and shellfish, where no significant differences were found (p < .05). Significant regional differences exist in allergenic food introduction, with North America recommending earlier introduction more often than Asia and South America, except for eggs and fish, which show consistent recommendations globally.

This global survey reveals a significant knowledge gap between allergists and non-allergists across all regions, with allergists consistently recommending earlier introduction more frequently than non-allergists. It also shows substantial regional disparities in food allergy prevention practices. These differences likely reflect varying levels of guideline adoption, cultural practices, and access to updated training. To reduce the worldwide burden of food allergies, efforts should focus on standardizing guidelines with regional adaptations, providing targeted education for non-allergists, and increasing awareness in regions with lower guideline adherence.