Preparing Patients for Oral Immunotherapy (PPOINT): International Delphi consensus for procedural preparation and consent

• DOI: 10.1016/j.jaci.2024.02.019
• Publication Date: 2024-04-08T09:06:48Z
• Authors: Douglas P. Mack; Timothy E. Dribin; Paul J. Turner; Richard L. Wasserman; Mariam A. Hanna; Marcus Shaker; Mimi L.K. Tang; Pablo Rodríguez d...; Brad Sobolewski; Elissa M. Abrams; Aikaterini Anagno...; Stefania Arasi; Sakina Bajowala; Philippe Bégin; Scott B. Cameron; Edmond S. Chan; Sharon Chinthrajah; Andrew T. Clark; Paul Detjen; George du Toit; Motohiro Ebisawa; Arnon Elizur; Jeffrey M. Factor; Justin Greiwe; Jonathan O’B Hour...; Sarah W. Hughes; Douglas H. Jones; Antonella Muraro; Anna Nowak-Wegrzyn; Nandinee B. Patel; Amy M. Scurlock; Atul N. Shah; Sayantani B. Sindher; Stephen Tilles; Brian P. Vickery; Julie Wang; Hugh H. Windom; Matthew Greenhawt
• Keywords: Oral immunotherapy; Delphi Method; Delphi

BackgroundDespite the promise of oral immunotherapy (OIT) to treat food allergies, this procedure is associated with potential risk. There no current agreement about what elements should be included in preparatory or consent process.ObjectiveWe developed consensus recommendations OIT process considerations and patient-specific factors that addressed before initiating a information form.MethodsWe convened 36-member Preparing Patients for Oral Immunotherapy (PPOINT) panel allergy experts develop patient preparation, informed process, framework form. Consensus themes statements was reached using Delphi methodology, form developed.ResultsThe expert 4 103 specific procedures, which 76 inclusion following themes: general counseling patients OIT; patient- family-specific during indications contraindications precautions OIT. The on 9 benefits, risks, outcomes, alternatives, risk mitigation, difficulties/challenges, discontinuation, office policies, long-term management. From these themes, 219 were proposed, 189 consensus, 71 form.ConclusionWe prepare counsel safe effective clinical practice evidence-based mitigation. Adoption may help standardize care improve outcomes quality life. Despite process. We developed.