Elements of Treatment Adherence in Children with Cow's Milk Protein Allergy.

Background: Adherence with treatment is critical for a successful outcome in cow's milk protein allergy (CMPA). Determination of the factors associated with non-adherence will enable us to develop effective approaches to increase the adherence rates, thus better cost-effectiveness of the treatment. The aim of this study was to identify the main factors associated with non-adherence with treatment for CMPA in children through the view of the physicians. Materials and methods: This focus-group study involved 51 pediatricians. Data were obtained using face-to-face surveys and subsequent discussions with the physicians. Results: Based on the treating physician's opinion, adherence to treatment was 65.7%. Of the patients, 55.4% and 29.3% were treated with an amino-acid-based formula (AAF) and an extensively hydrolyzed formula (eHF) with the tolerability rates of 77.4% and 77.2%, respectively. Remaining patients were treated with elimination diet. For patient-related factors, CMPA severity and the existence of underlying morbidities, of family-related factors, the education level of the family and their confidence in the treatment, and of product-related factors, product taste/aroma and formula choice were most strongly associated factors with treatment adherence. Conclusions: The main obstacles in treating CMPA in clinical practice were intolerability or incorrect use of the formula, dislike of its flavor and odor, and difficulties in implementation of elimination diet by parents. Determination of the factors associated with non-adherence is important in order to develop effective strategies to increase the adherence rates which will in turn improve the outcome and cost-effectiveness of the treatment. [ABSTRACT FROM AUTHOR]