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New guidance on nut allergies for primary care nurses follows continued rise in cases

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Clinicians can now draw on new comprehensive guidance to help them treat patients with nut allergies with numbers affected by the condition continuing to rise.

The guidance, published by the British Society for Allergy and Clinical Immunology, aims to improve the diagnosis and management of peanut and tree nut allergy by bringing together the latest research evidence and providing practical advice for healthcare professionals.

“We wanted to combine practical advice with a summary of current thinking on a range of issues”

Andrew Clark

The society said the new guidelines were sorely needed in the light of a continued increase in the numbers of people with allergies and a rise in the number of deaths, particularly among younger patients, since the early 1990s.

Meanwhile, various factors had led to inconsistencies in diagnosis and “widespread confusion and mis-identification” of allergies.

The society said some people were going undiagnosed, while others were avoiding nuts unnecessarily because they had incorrectly diagnosed themselves with an allergy.

The new guidance is mainly aimed at clinicians in general practice who deal with patients with allergy concerns on a regular basis, helping them prioritise patients in need of further investigation and provide ongoing support.

New and updated areas covered by the guideline include advice on identifying high risk groups – such as young children with severe eczema or an egg allergy – and details of the latest generation of allergy tests.

The guidance highlights the latest thinking on allergy management, particularly for children, with a focus on a more holistic, systematic approach that involves key people such as grandparents as well as nurseries and schools.

It also covers developments in the field such as new approaches to weaning babies that involve introducing peanut protein, which could help reduce the number of adults with nut allergies in the future, and peanut oral immunotherapy – a way of building up a tolerance by gradually introducing children to nut protein.

Dr Andrew Clark, one of the lead authors of the guidance, hoped the document would be of real benefit to those treating people with nut allergies.

“We wanted to combine practical advice with a summary of current thinking on a range of issues, from new tests to immunotherapy – something that was urgently needed given the extensive debate on all these areas,” he said.

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