Allergy to Peanuts imPacting Emotions And Life (APPEAL) study. The impact of peanut allergy on children, teenagers, adults and caregivers in Germany

Background. Peanut allergy (PA) has been reported to affect up to 3% of children in developed countries. The Allergy to Peanuts imPacting Emotions And Life study (APPEAL) is the first large study to investigate the impact and burden of living with PA in patients and their caregivers. Material and methods. Children, teenagers and adults with PA and their caregivers completed either an online questionnaire (APPEAL-1, n= 273) or provided in-depth interviews (APPEAL-2, n= 32). Results. Of the responders in APPEAL-1 (56 adult patients with PA and 217 parents and caregivers of persons with PA), 85% stated that PA affects their daily activities and 65% felt isolated as a result of living with PA. Feelings of worry about potential exposure to peanuts on social occasions where food is involved were reported by 91% and a total of 85% reported restrictions in socializing. The psychological impact of PA included feelings of frustration (89%), uncertainty (86%) and stress (88%). A large proportion of responders (84%) reported a feeling of differentness due to PA. The main factors that drove the impact of PA included social and school activities, relationships, emotional well-being, and work (parents and caregivers). The main coping strategies to avoid peanuts included monitoring of food and hygiene, communication with others and detailed planning of activities. Conclusion. This is the first real-world survey in Germany to demonstrate the impact and burden of a PA on and unmet needs of allergic children, teenagers and their parents or caregivers as well as affected adults.