P215 ‘Have you put the fear of god into anyone today?’ – an audit measuring short term compliance with allergy clinic advice to introduce ‘safe’ foods

Aims To asses short term compliance with advice to introduce SKIN TEST NEGATIVE foods after clinic. To asses barriers to commencing advised consumption. Methods Allergy-related dietary restrictions are often too broad, and are not based on clinical evidence of allergy or sensitisation. In CUH allergy clinic parents are advised to introduce foods after full allergy focused history, usually negative SPT and occasionally IgE testing. Parents are given a written list of foods to be introduced and are advised that they will be contacted in exactly one week to inquire about (non-)completion of the introductions. Results 75 parents were contacted 1 week after their clinic visit. 10 parents (13%) failed to commence food as instructed with reasons such as ‘child refusal’, ‘forgot’ and child vomiting immediately post ingestion. 65 (87%) commenced foods as planned, most were asked to try tree nuts with only 6 parents 13%) asked to start the egg or milk ladder. 55 of these parents were asked to introduce more than one food (up to 6 foods), 10 of the 55 parents failed to introduce more than one food (18%) and 45 completed all advised introductions (82%). Reasons given for incomplete multiple introductions were ‘not enough time since clinic’ and fear of introducing more than one food would cause a reaction.47 parents (72%) gave the advised foods more than once/regularly in the week, (18) 27% parents gave the advised foods just once so far , but 13 of these 18 were willing to offer the foods again. Conclusion 87% of parent introduced advised food(s) within 1 week, but only 72% were offering the foods regularly. Reasons for non-compliance were usually not allergy-related and can be worked around, including giving a wider time window for multiple introductions. Introduction of unduly avoided foods is a key part of modern allergy care.