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Background: Allergy to Peanuts ImPacting Emotions And Life (APPEAL‐1) was a recent European multi‐country questionnaire survey that highlighted the negative impacts of peanut allergy (PA) on quality of life. A follow‐on qualitative study, APPEAL‐2, further assessed the burden of PA and associated coping strategies through semi‐structured interviews. Objective: To gain qualitative insight on the strategies used to cope with and manage PA and the impact of these strategies on the quality of life of children, teenagers and caregivers. Methods: This cross‐sectional qualitative study was conducted in eight European countries: the United Kingdom, France, Germany, Ireland, Spain, Italy, Denmark and the Netherlands. Semi‐structured interviews were conducted with children (aged 8‐12 years) and teenagers (aged 13‐17 years) with self‐/proxy‐reported moderate or severe PA and with parents/caregivers of children or teenagers (aged 4‐17 years) with moderate or severe PA. Data were analysed using thematic analysis; data saturation was assessed. Two conceptual models were developed to illustrate the impacts of PA and coping strategies used to manage them for (a) individuals with PA and (b) parents/caregivers of children with PA. Results: 107 participants were interviewed: 24 children, 39 teenagers and 44 caregivers. The conceptual models illustrated themes related to coping and control, driven by the fear of PA reactions, and the associated emotional, social, relationship and work impacts. Factors moderating these impacts included social attitudes and support, child‐caregiver relationship and coping strategies used. Conclusions and Clinical Relevance: The APPEAL‐2 results substantiate the findings of APPEAL‐1; the results also suggest that the severity of experience with PA may not correlate with perception of its overall burden and show variable impacts by country. [ABSTRACT FROM AUTHOR]

Background: Limited research has examined the impact of peanut allergy (PA) on children using validated instruments to assess psychosocial burden and the factors influencing burden. Objective: The PAPRIQUA study aimed to assess the caregiver‐reported impact of living with PA on children's health‐related quality of life (HRQL), correlations between PA severity and child's sex, and associations of caregivers' sex and anxiety with the proxy report of their child's HRQL and to identify significant predictors of a child's HRQL. Methods: A cross‐sectional survey of caregivers of children with mild, moderate and severe PA, based on caregiver perception, was conducted in the United Kingdom. Participants were recruited through a survey recruitment panel; a maximum quota of 20% who rated their child's PA as mild was set to ensure population diversity; however, the quota was not required as few participants considered their child's PA mild. The survey, funded by Aimmune Therapeutics, included sociodemographic and clinical questions, the EQ‐5D‐Y, Hospital Anxiety and Depression Scale, Food Allergy Quality of Life Questionnaire‐Parent Form (FAQLQ‐PF) and Food Allergy Independent Measure (FAIM). Results: One hundred caregivers of children with PA (aged 4‐15 years) completed the survey. Child's sex was not associated with proxy‐reported burden. For younger children (aged 4‐10 years), there was no effect of PA severity; parents of older children (aged 11‐15 years) reported low to higher burden for their child on the EQ‐5D‐Y and FAQLQ‐PF dependent upon PA severity. For all measures of child burden except the EQ‐5D‐Y, two or more reactions in the past 12 months and parental anxiety significantly predicted higher levels of burden for the child (P <.05–P <.001). Experiencing a life‐threatening event in the past 12 months significantly predicted EQ‐5D‐Y proxy utility (P <.01). Conclusions and Clinical Relevance: Caregivers report that children with PA experience high levels of psychosocial burden, particularly those with more severe PA and a reaction history. Interventions to decrease caregiver anxiety and reaction frequency may help reduce the child's burden. Self‐report studies in children with PA would help confirm these findings. [ABSTRACT FROM AUTHOR]