Food Allergy in New Zealand Adults: Insights from ACC data and a General Practitioners survey

Abstract

Food allergy (FA) is a significant public health concern that may be becoming more prevalent. This thesis aimed to examine FA in New Zealand with a focus on financial support from the Accident Compensation Corporation (ACC) and on FA in adults. This was explored through three complementary studies; a literature review, analysis of (ACC) claims data, and a survey of General Practitioners (GPs). A narrative review of the literature explored and critiqued published FA research. Key issues highlighted included diagnosis and management, risk factors, prevalence and its changes over time, impacts on quality of life, and burden of disease. Records for FA-related claims by adults were collected from ACC for a 5 year period (2009-2013). During this time a total of $504,455 was paid by ACC for 3,037 probable FA claims. There was no significant change in the annual number of probable FA claims during this period. There was a substantial difference in the proportion of probable FA claims accepted in 2009 (78.2 %) compared to subsequent years (54.9 - 56.3 %). Claims were more likely to be accepted if the claim description named a specific causative food or outlined a history of FA. Seafood was the most common food type implicated, followed by nuts. A survey of a sample of New Zealand GPs was conducted to explore management of FA in primary care, including knowledge of ACC coverage of FA expenses. This was distributed via email and 17 complete responses were received. Most GPs surveyed believe FA prevalence is increasing. Few GPs had a solid understanding of whether FA costs can be claimed from ACC. The majority reported that they would like further training on FA and identified key areas of concern, including diagnostics and access to specialists. Together, the three studies within this thesis demonstrate the importance of FA as a public health concern with substantial impacts on individuals, families, health systems and economies. The results of this thesis highlight the importance of training for GPs, including education on ACC entitlements. Further research is needed to better understand the burden of FA, globally and in New Zealand.