Participants and procedure
Adult participants (aged ≥18 years) with a diagnosis of anaphylaxis meeting the World Allergy Organization (WAO) diagnostic criteria2 as assessed by a specialist in allergy were recruited from allergy clinics in University Hospitals Birmingham (UHB) NHS Foundation Trust, Birmingham, UK. Patients were excluded if they lacked English language proficiency or if they lacked capacity to provide informed consent. The UHB Allergy service is an accredited centre by The Royal College of Physicians of London under the Improving Quality in Allergy Services (IQAS) program and was designated as a WAO centre of excellence in 2020. The service receives referrals from within Birmingham and beyond including Coventry and Warwickshire, Staffordshire, Shropshire and South Wales.
Patients were systematically assessed by a detailed clinical history and allergy tests as per British Society for Allergy and Clinical Immunology (BSACI) and European Association of Allergy and Clinical Immunology (EAACI) guidelines13-19. All eligible participants who attended the clinics were provided with a study participant information sheet by health care professionals at the allergy clinic. If they wanted to take part, they were asked to sign a consent form and complete the questionnaires in clinic or take them home for completion. If they took the questionnaires home, they were provided with an envelope with a stamp and a return address to post back to RK’s study team at Aston University, Birmingham. All completed questionnaire packs were separated from consent forms, assigned a study code and analysed anonymously.