Factors Influencing Health-Related Quality of Life for Adolescents with Peanut Allergy

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New data on peanut allergy and Pediatric Quality of Life Inventory scores sheds light on the burden of allergy on adolescents.

Three factors significantly were found to influence Pediatric Quality of Life Inventory 4.0 (PedsQL) total scores for adolescents with peanut allergy (PA), according to recent findings.1

These 3 factors included experiencing a severe reaction upon touching peanuts, being in complete agreement on avoiding peanuts, and dissatisfaction with prophylaxis. This research was authored by Danmeng Huang, from Xcenda LLC in Texas.

PA may influence patients or caregiver's health-related quality of life (HRQoL), and prior research has examined these impacts of PA on HRQoL measures including social dysfunction for children and adolescents.

“Despite these results, there is a paucity of HRQoL data and studies specifically evaluating the experience of adolescents with PA,” Huang and colleagues wrote. “The goal of this analysis was to utilize PABS data to identify potential predictors of Pediatric Quality of Life Inventory 4.0 (PedsQL) scores in adolescents with PA to add to the literature base and improve management opportunities for these patients.”

Background and Findings

The investigators used an analysis of the Peanut Allergy Burden Study (PABS), which had involved a cross-sectional survey that was used to evaluate the impact of PA on peanut-allergic teenagers, adults, and caregivers of peanut-allergic children.2

They conducted a sub-analysis on the peanut-allergic adolescent sample to assess the real-world factors that might predict their PedsQL scores. The PABS study in general was a prospective online survey which recruited 102 adolescents who had self-reported diagnoses of PA.

The researchers collected the necessary data from November 2018 to January 2019, and the survey including questions demographics as well as the following:

  • Medical and treatment information
  • General HRQoL measures
  • Mental, physical, and social health
  • Dynamics with family and burden on caregivers
  • Treatment satisfaction
  • Healthcare resource utilization
  • Productivity with work, home activities, and school

The study’s final model was made up of 10 variables that were shown to have substantially affected the participants’ PedsQL total scores.

These included race, reported strict peanut avoidance, satisfaction with prophylaxis, moderate-to-severe reaction in the past 12 months, touching peanut as the cause of most severe reaction, fear of reaction, age, gender, comorbidities, and daily life limitations.

Overall, the investigators found that the 3 biggest factors which emerged as strong predictors of the PedsQL total score were the cause of the severe reaction being touching peanuts, complete agreement with avoiding peanuts, and dissatisfaction with prophylaxis.

The investigators noted that when their model was applied to patient scores of individuals, they observed greater heterogeneity in the drivers of the results. This led them to conclude that the nature of successful management PA for adolescents is complex, to say the least.

“These results are aligned with previous literature reporting a wide variety of HRQoL score drivers among different patient age groups, ethnicities, and countries of origin,” they wrote.

The team added that their research demonstrates the necessity of shared decision-making for management of PA for adolescents in order to address HRQoL.


  1. McCann, WA, Nowak-Wegrzyn, A, Hass, SL, Huang, D, Donelson, SM. Peanut allergy burden survey: factors associated with health-related quality of life in adolescents. Clin Transl Allergy. 2023;e12234.
  2. McCann W, Hass SL, Norrett K, et al. The Peanut Allergy Burden Study: real-world impact of peanut allergy on resource utilization and productivity. World Allergy Organ J. 2021;14(3):100525.