D3.220 - Real-World Management of Pediatric Allergic Diseases: A Nationwide Physician Survey among Allergists and Pediatric Allergists in Turkey

Pediatric allergic diseases represent a significant and increasing healthcare burden worldwide. Early diagnosis and appropriate management are essential to improve long-term outcomes and quality of life. Allergen immunotherapy (AIT) remains the only disease modifying treatment for IgE-mediated allergic diseases. Understanding real-world clinical practices is crucial to identify gaps in care and optimize therapeutic strategies.

A structured questionnaire realized by a board of international experts, was distributed to 587 members of the Turkish National Society of Allergy and Clinical Immunology, including allergists and pediatric allergists, to collect insights on their clinical experience in managing pediatric allergic diseases. The survey investigated diagnostic practices, therapeutic approaches, AIT prescription patterns, perceived treatment adherence, and barriers to optimal management.

Responses indicate that AIT is routinely prescribed in pediatric clinical practice and is considered a central component of long-term disease management. Treatment adherence is generally perceived as satisfactory in specialized settings, although variability is reported.

Skin prick testing and serum specific IgE measurement emerge as the most used diagnostic tools, frequently complemented by component resolved diagnostics in more complex or polysensitized cases.

Key challenges include parental hesitancy toward immunotherapy, concerns regarding safety and long-term commitment, and logistical or organizational barriers that may limit access to specialized care. Both subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) are used in clinical practice, with SCIT appearing more frequently prescribed, either alone or in combination with SLIT. Economic and reimbursement aspects are also reported as influencing factors in treatment decisions.

House dust mite and pollen allergens appear to be among the most frequently targeted in immunotherapy prescriptions. In polysensitized children, individualized treatment strategies are commonly adopted. Clinical outcomes are perceived to be influenced by early intervention, appropriate patient selection, and sustained adherence over time.

This survey provides real-world insights into pediatric allergy management at a national level. Although AIT is widely integrated into clinical practice, practical, perceptual, and organizational barriers persist. These findings may inform future educational initiatives and healthcare strategies aimed at optimizing pediatric allergy care.