182 Perceptions of Caregivers of Patients with Cow Milk Allergy Regarding the Treatment

BACKGROUND: To understand the perceptions of caregivers of patients with cow milk allergy (CMA) regarding the disease and its treatment. METHODS: Qualitative study in which caregivers of children and adolescents with confirmed CMA followed, at least, for 1 year, were interviewed. They were recruited from outpatient clinic of Allergy and Immunology Division from a tertiary pediatric hospital in São Paulo, Brazil. The interviews were conducted under conditions of privacy and 2 opened questions were proposed: “Tell me about your experience with cow's milk allergy treatment” and “What do you expect from your child's disease treatment?” Data were audio-recorded, transcribed, analyzed using the content analysis method and categories and subcategories were generated based on their speeches. RESULTS: Nine interviews were done and 3 categories with subcategories emerged: A. Treatment and education of the patient and their caregivers (life experiences, bases of treatment, coping with the disease). B. Resolution of the disease (hope, gradual improvement). C. Quality of life (social inclusion, family daily activities, costs of dietary treatment). Caregivers experienced difficulties during the initial treatment but pointed out that the guidance given during follow-up made the adjustments easier. They also compared CMA with other chronic diseases and highlighted the importance of their children follow-up in this institution for adequate control. They commented on the difficulties about lack of cooperation from other family members regarding the restrictive diet, their experience coping with allergic reactions, doubts about the treatment and gaps on knowledge about the disease by other physicians and people. The majority of relatives was satisfied with the gradual improvement of patients, although there are no drugs or vaccines for treatment, and observed a reduction on the severity of symptoms and tolerance of milk traces. In addition, they commented on the efforts to give a normal life for their children, the changes in their daily lives and the difficulty to buy special products. CONCLUSIONS: This qualitative study allowed us to understand how families cope with the disease, their histories and hopes about the treatment. They feel a great burden of the disease and need support and orientation from health professionals.