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Marklund, Birgitta
Publications (10 of 10) Show all publications
Protudjer, J. L., Jansson, S.-A., Middelveld, R., Ostblom, E., Dahlen, S.-E., Arnlind, M. H., . . . Ahlstedt, S. (2016). Impaired health-related quality of life in adolescents with allergy to staple foods. Clinical and Translational Allergy, 6, Article ID 37.
Open this publication in new window or tab >>Impaired health-related quality of life in adolescents with allergy to staple foods
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2016 (English)In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 6, article id 37Article in journal (Refereed) Published
Abstract [en]

Background: Cow's milk, hen's egg and wheat are staple foods in a typical western diet. Despite the ubiquity of these foods, the impact of staple food allergy on health-related quality of life (HRQL) amongst adolescents is incompletely understood. The aims of this study were to make use of the Swedish version of EuroPrevall's disease-specific food allergy quality of life questionnaire-teenager form (FAQLQ-TF) and to investigate the association between objectively-diagnosed staple food allergy and HRQL amongst adolescents. Methods: In this cross-sectional study, 58 adolescents aged 13-17 years [n = 40 (69 %) boys] with objectively-diagnosed allergy to the staple foods cow's milk, hen's egg and/or wheat and living in Stockholm, Sweden were included. Adolescents completed the FAQLQ-TF, which has a corresponding scale of 1 = best HRQL, and 7 = worst HRQL. Overall HRQL and domain-specific HRQL were established. Adolescents also reported symptoms, adrenaline auto injector (AAI) prescription and presence of other food allergies. A history of anaphylaxis was defined among those reporting difficulty breathing, inability to stand/collapse, and/or loss of consciousness. Clinically different HRQL was set at a mean difference of >= 0.5. Results: Overall mean HRQL was poorer than average [mean: 4.70/7.00 (95 % CI 4.30-5.01)]. The domain risk of accidental exposure was significantly associated with clinically better HRQL than the domain allergen avoidance and dietary restrictions (mean difference = 0.76; p < 0.001). Girls had clinically worse, but not statistically significantly different mean HRQL than boys (mean difference = 0.71; p < 0.07). HRQL tended to be worse amongst those with allergies to more than three foods or an AAI prescription. The number and types of symptoms, including a history of anaphylaxis were not associated with worse HRQL. Conclusions: As ascertained via a food allergy-specific questionnaire, adolescents with staple food allergy report poorer than average HRQL, specifically in relation to emerging independence and the need for support. Girls have clinically worse HRQL than boys. The number and type of previous symptoms and history of anaphylaxis were not associated with worse HRQL.

Keywords
Adolescents, Food allergy, Health-related quality of life
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-59814 (URN)10.1186/s13601-016-0128-5 (DOI)000390120200001 ()27733903 (PubMedID)2-s2.0-85006272256 (Scopus ID)
Available from: 2017-01-16 Created: 2017-01-13 Last updated: 2017-11-29Bibliographically approved
Protudjer, J. L., Jansson, S.-A., Ostblom, E., Arnlind, M. H., Bengtsson, U., Dahlen, S.-E., . . . Ahlstedt, S. (2015). Health-related quality of life in children with objectively diagnosed staple food allergy assessed with a disease-specific questionnaire. Acta Paediatrica, 104(10), 1047-1054
Open this publication in new window or tab >>Health-related quality of life in children with objectively diagnosed staple food allergy assessed with a disease-specific questionnaire
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2015 (English)In: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 104, no 10, p. 1047-1054Article in journal (Refereed) Published
Abstract [en]

Aim: Among Swedish children of 0-12 years old, we investigated various food allergy-related exposures associated with health-related quality of life using a food allergy-specific questionnaire among children allergic to the staple foods cow's milk, hen's egg and/or wheat, and contextualised worse food allergy-associated health-related quality of life using a generic questionnaire versus controls. Methods: In total, 85 children with objectively diagnosed allergy to the staple foods were included as cases, and 94 children matched for age and sex were included as controls. We administered a food allergy-specific parent-completed questionnaire originally developed by EuroPrevall to cases only, and a generic health-related quality of life questionnaire (EuroQol Health Questionnaire, 5 Dimensions; EQ 5-D); to both cases and controls. Results: Hen's egg was the most common offending staple food, affecting 76% of cases. Approximately 7% of cases were allergic to all three staple foods. Parent-reported respiratory and cardiovascular symptoms were associated with worse health-related quality of life. Elements of disease severity [previous anaphylaxis (p < 0.001); epinephrine autoinjector prescription (p < 0.003)] were negatively associated with health-related quality of life. Cases had worse health-related quality of life measured by the EQ-5D compared to controls (p < 0.01). Conclusion: The use of a disease-specific questionnaire revealed that disease severity in children with objectively diagnosed allergy to the staple foods cow's milk, hen's egg and/or wheat is associated with worse health-related quality of life. The use of a generic questionnaire confirmed that cases have worse health-related quality of life than controls.

Keywords
Children, Food allergy, Food hypersensitivity Health-related quality of life
National Category
Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-46976 (URN)10.1111/apa.13044 (DOI)000362512100025 ()25983039 (PubMedID)2-s2.0-84941942146 (Scopus ID)
Available from: 2015-10-30 Created: 2015-10-30 Last updated: 2017-12-01Bibliographically approved
Protudjer, J. L. P., Jansson, S.-A., Arnlind, M. H., Bengtsson, U., Källström-Bengtsson, I., Marklund, B., . . . Ahlstedt, S. (2015). Household Costs Associated with Objectively Diagnosed Allergy to Staple Foods in Children and Adolescents. Journal of Allergy and Clinical Immunology-In Practice, 3(1), 68-75
Open this publication in new window or tab >>Household Costs Associated with Objectively Diagnosed Allergy to Staple Foods in Children and Adolescents
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2015 (English)In: Journal of Allergy and Clinical Immunology-In Practice, ISSN 2213-2198, Vol. 3, no 1, p. 68-75Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: We previously reported that indirect and intangible costs burden households with a food allergic adult. We now extend our investigation to households with food allergic children and adolescents. OBJECTIVE: The objective of this study was to estimate direct, indirect, and intangible costs of food allergy in households with a child and/or adolescent with objectively diagnosed allergy to staple foods (cow's milk, hen's egg, and/or wheat), and to compare these costs with age-and sex-matched controls. METHODS: Direct and indirect cost parent-reported data collected via the Food Allergy Socio-Economic Questionnaire of 84 children (0-12 years) and 60 adolescents (13-17 years) with objectively diagnosed allergy to staple foods ("cases") and age- and sex-matched controls (n = 94 children; n = 56 adolescents) were compared. Annual household costs were calculated. Total household costs included direct plus indirect costs. Intangible costs included parent-reported health of their child and/or adolescent, standard of living, and perceptions of well-being. RESULTS: Amongst cases, total household costs were higher by (sic)3961 for children and (sic)4792 for adolescents versus controls (P < .05), and were driven by direct (eg, medications) and indirect (eg, time with health care professionals) costs. For children only, a history of anaphylaxis was associated with higher direct costs than no anaphylaxis ((sic)13,016 vs (sic)10,044, P < .05). Intangible costs (eg, parent-reported health of a child and/or adolescent) were significantly impacted amongst cases versus controls (P < .01). CONCLUSION: Households with a child and/or adolescent with objectively diagnosed allergy to staple foods have higher total household costs than controls. Direct and indirect costs were significantly higher for cases versus controls amongst children only. Amongst both age groups, such allergy adversely impacted intangible costs. (C) 2015 The Authors. Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.

Keywords
Adolescents, Children, Direct costs, Food allergy
National Category
Respiratory Medicine and Allergy Nursing
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-46293 (URN)10.1016/j.jaip.2014.09.021 (DOI)000354210100010 ()25577621 (PubMedID)2-s2.0-84920861918 (Scopus ID)
Available from: 2015-09-14 Created: 2015-09-14 Last updated: 2015-09-14Bibliographically approved
Jansson, S.-A. -., Protudjer, J. L., Heibert, M. A., Bengtsson, U., Kallstrom-Bengtsson, I., Marklund, B., . . . Ahlstedt, S. (2014). Socioeconomic evaluation of well-characterized allergy to staple foods in adults. Allergy. European Journal of Allergy and Clinical Immunology, 69(9), 1241-1247
Open this publication in new window or tab >>Socioeconomic evaluation of well-characterized allergy to staple foods in adults
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2014 (English)In: Allergy. European Journal of Allergy and Clinical Immunology, ISSN 0105-4538, E-ISSN 1398-9995, Vol. 69, no 9, p. 1241-1247Article in journal (Refereed) Published
Abstract [en]

Background: The aim of the present study was to evaluate if total, direct, indirect, and intangible costs differ between a cohort of adults with well-characterized allergy to staple foods ('cases') and controls. Methods: Swedish adults with objectively diagnosed food allergy to cow's milk, hen's egg, and/or wheat were recruited at an outpatient allergy clinic. Controls age- and sex-matched to cases were recruited from the same geographic area. For assessing the household costs of food allergy, a disease-specific socioeconomic questionnaire, developed within EuroPrevall, was utilized. Results: Overall annual total costs at the household level were significantly higher among adults with food allergy compared with controls (the difference amounted to 8164 (sic) ), whereas direct costs did not differ between cases and controls. However, household healthcare costs and costs for medicines were significantly higher for cases vs controls. Furthermore, indirect costs were significantly higher for households with food-allergic adults vs households without food-allergic adults. Specifically, more time was spent on performing domestic tasks due to a family member's food-allergy-related illness, as well as shopping and preparing food, and seeking food-allergy-related information. Presence of food allergy also affected intangible costs. Adults with food allergy experienced overall lower health status compared with controls. Conclusions: Swedish adults with allergy to staple foods have higher total costs determined as direct, indirect, and intangible costs using the disease-specific socioeconomic questionnaire. Thus, total costs were 8164 (sic) higher per year in households with at least one adult allergic to staple foods compared with controls.

Keywords
adults, food allergy, household costs
National Category
Respiratory Medicine and Allergy
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-37356 (URN)10.1111/all.12443 (DOI)000340864900013 ()2-s2.0-84905819077 (Scopus ID)
Available from: 2014-09-29 Created: 2014-09-29 Last updated: 2017-12-05Bibliographically approved
Jansson, S.-A., Heibert-Arnlind, M., Middelveld, R. J., Bengtsson, U. J., Sundqvist, A.-C., Kallström-Bengtsson, I., . . . Ahlstedt, S. (2013). Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods. Clinical and Translational Allergy, 3(21)
Open this publication in new window or tab >>Health-related quality of life, assessed with a disease-specific questionnaire, in Swedish adults suffering from well-diagnosed food allergy to staple foods
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2013 (English)In: Clinical and Translational Allergy, ISSN 2045-7022, E-ISSN 2045-7022, Vol. 3, no 21Article in journal (Refereed) Published
Abstract [en]

Background

Our aim was to investigate the factors that affect health related quality of life (HRQL) in adult Swedish food allergic patients objectively diagnosed with allergy to at least one of the staple foods cow’s milk, hen’s egg or wheat. The number of foods involved, the type and severity of symptoms, as well as concomitant allergic disorders were assessed.

Methods

The disease-specific food allergy quality of life questionnaire (FAQLQ-AF), developed within EuroPrevall, was utilized. The questionnaire had four domains: Allergen Avoidance and Dietary Restrictions (AADR), Emotional Impact (EI), Risk of Accidental Exposure (RAE) and Food Allergy related Health (FAH). Comparisons were made with the outcome of the generic questionnaire EuroQol Health Questionnaire, 5 Dimensions (EQ-5D). The patients were recruited at an outpatient allergy clinic, based on a convincing history of food allergy supplemented by analysis of specific IgE to the foods in question. Seventy-nine patients participated (28 males, 51 females, mean-age 41 years).

Results

The domain with the most negative impact on HRQL was AADR, assessing the patients’ experience of dietary restrictions. The domain with the least negative impact on HRQL was FAH, relating to health concerns due to the food allergy. One third of the patients had four concomitant allergic disorders, which had a negative impact on HRQL. Furthermore, asthma in combination with food allergy had a strong impact. Anaphylaxis, and particularly prescription of an epinephrine auto-injector, was associated with low HRQL. These effects were not seen using EQ-5D. Analyses of the symptoms revealed that oral allergy syndrome and cardiovascular symptoms had the greatest impact on HRQL. In contrast, no significant effect on HRQL was seen by the number of food allergies.

Conclusions

The FAQLQ-AF is a valid instrument, and more accurate among patients with allergy to staple foods in comparison to the commonly used generic EQ-5D. It adds important information on HRQL in food allergic adults. We found that the restrictions imposed on the patients due to the diet had the largest negative impact on HRQL. Both severity of the food allergy and the presence of concomitant allergic disorders had a profound impact on HRQL.

Keywords
Food allergy, Adults; Health-related quality of life, Instrument, Questionnaire
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-30642 (URN)10.1186/2045-7022-3-21 (DOI)23816063 (PubMedID)2-s2.0-85006154543 (Scopus ID)
Projects
FoodHE, Karolinska Institutet
Available from: 2013-11-22 Created: 2013-11-22 Last updated: 2017-12-06Bibliographically approved
Marklund, B., Wilde-Larsson, B., Ahlstedt, S. & Nordström, G. (2007). Adolescents' experiences of being food-hypersensitive: a qualitative study. BMC Nursing
Open this publication in new window or tab >>Adolescents' experiences of being food-hypersensitive: a qualitative study
2007 (English)In: BMC Nursing, ISSN 1472-6955, E-ISSN 1472-6955Article in journal (Refereed) Published
National Category
Medical and Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-2292 (URN)
Available from: 2010-04-07 Created: 2010-04-07 Last updated: 2017-12-12Bibliographically approved
Marklund, B., Ahlstedt, S. & Nordström, G. (2007). Food hypersensitivity and quality of life. Current Opinion in Allergy and Clinical Immunology, 7, 279-287
Open this publication in new window or tab >>Food hypersensitivity and quality of life
2007 (English)In: Current Opinion in Allergy and Clinical Immunology, ISSN 1528-4050, E-ISSN 1473-6322, Vol. 7, p. 279-287Article, review/survey (Other academic) Published
National Category
Medical and Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-5079 (URN)
Available from: 2010-04-28 Created: 2010-04-28 Last updated: 2017-12-12Bibliographically approved
Marklund, B., Ahlstedt, S. & Nordström, G. (2006). Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptions. Health and Quality of Life Outcomes
Open this publication in new window or tab >>Health-related quality of life in food hypersensitive schoolchildren and their families: parents' perceptions
2006 (English)In: Health and Quality of Life OutcomesArticle in journal (Refereed) Published
National Category
Medical and Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-2356 (URN)10.1186/1477-7525-4-48 (DOI)
Available from: 2010-04-07 Created: 2010-04-07 Last updated: 2011-10-04Bibliographically approved
Marklund, B., Gunnarsson, N., Ahlstedt, S., Borell, L. & Nordström, G. (2005). Allergy-like conditions and helath-care contacts among children with exclusion diets at school. Scandinavian Journal of Caring Sciences, 19, 46-52
Open this publication in new window or tab >>Allergy-like conditions and helath-care contacts among children with exclusion diets at school
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2005 (English)In: Scandinavian Journal of Caring Sciences, Vol. 19, p. 46-52Article in journal (Refereed) Published
National Category
Health Sciences
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-2355 (URN)
Available from: 2010-04-07 Created: 2010-04-07 Last updated: 2011-09-30Bibliographically approved
Marklund, B., Ahlstedt, S. & Nordström, G. (2004). Health-related quality of life among adolescents with allergy-like conditions - with emphasis on food hypersensitivity. Health and Quality of Life Outcomes
Open this publication in new window or tab >>Health-related quality of life among adolescents with allergy-like conditions - with emphasis on food hypersensitivity
2004 (English)In: Health and Quality of Life OutcomesArticle in journal (Refereed) Published
Research subject
Health and Caring Sciences
Identifiers
urn:nbn:se:lnu:diva-2354 (URN)
Available from: 2010-04-07 Created: 2010-04-07 Last updated: 2011-09-29Bibliographically approved
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