Impact of a dietitian in general practice: Paediatric food allergy.

BACKGROUND: Food allergy in infants and young children places a significant burden on primary care. This study evaluated a dietetic-led paediatric food allergy service, which attempts to provide more rapid access to the dietitian and reduce the need for general practitioner (GP) and secondary care appointments. METHODS: Two community dietetic services for children referred with food allergy were compared. The first was dietetic-led care where dietitians train community children's nurses to recognise potential cases of food allergy, undertake basic diagnostic assessment and subsequently refer to the dietitian. The other is a more traditional dietetic community service where patients are referred predominantly by the GP or secondary care. RESULTS: In dietetic-led care 86 patients were seen, compared to 96 in dietetic community care. Dietetic-led care received less referrals from the GP; 36% vs 67% (p<0.001), GP appointments for allergy-related conditions prior to dietetic referral were lower; 3 vs 6 visits (p=0.001) and input from secondary care was also lower; 8 vs 25 patients (p=0.002) compared with dietetic community care. Children referred to dietetic-led care were younger; 78% <6 months vs 40% (p