A Quality-of-life Study in Patients with Anaphylaxis to Hymenoptera Venom in Iran
-
Mohammad Hasan Bemaniyan
,
Maryam Heidari
,
Marzieh Tavakol
,
Mohammad Nabavi
,
Fatemeh Ramezani Kashal
,
Maryam Gholami
,
Bita Bemaniyan
Abstract
Little is known about the quality of life of patients with anaphylaxis to Hymenoptera venom. The Vespid Allergy Quality of Life Questionnaire (VQLQ) is commonly used to assess the psychological burden of this condition. This study aimed to evaluate the validity and reliability of the Persian version of VQLQ.
In this cross-sectional study, VQLQ was translated into Persian according to expert recommendations. The final translated version of VQLQ was then administered to 115 patients with Hymenoptera venom allergy at an asthma and allergy clinic in Iran.
More than half of the participants were between 20 and 40 years of age, and 60% were male. Fear, anxiety, and outdoor activities had the most significant impact on the quality of life of patients with Hymenoptera venom allergy. Additionally, quality of life was more affected in women than in men, while no correlation was found with age. Furthermore, the quality of life was affected by a history of acute anaphylactic shock due to Hymenoptera venom.
The Persian version of VQLQ enables the measurement of quality of life in patients with Hymenoptera venom allergy in the Iranian population. The inclusion of VQLQ in the initial evaluation of these patients may potentially guide allergist in providing support for venom-specific immunotherapy.
1. Baiardini I, Braido F, Bindslev-Jensen C, Bousquet PJ, Brzoza Z, Canonica GW, et al. Recommendations for assessing patient-reported outcomes and health-related quality of life in patients with urticaria: a GA(2) LEN taskforce position paper. Allergy. 2011;66(7):840-4.
2. Voll-Aanerud M, Eagan TML, Wentzel-Larsen T, Gulsvik A, Bakke PS. Asthma and health-related quality of life – effect of adjusting for potential confounders. The Clinical Respiratory Journal. 2008;2(2):106-15.
3. Leynaert B, Neukirch C, Liard R, Bousquet J, Neukirch F. Quality of life in allergic rhinitis and asthma. A population-based study of young adults. Am J Respir Crit Care Med. 2000;162(4 Pt 1):1391-6.
4. van der Velde JL, Dubois AE, Flokstra-de Blok BM. Food allergy and quality of life: what have we learned? Curr Allergy Asthma Rep. 2013;13(6):651-61.
5. Zuberbier T, Lötvall J, Simoens S, Subramanian SV, Church MK. Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review. Allergy. 2014;69(10):1275-9.
6. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118(8):622-9.
7. Aaronson NK. Quality of life assessment in clinical trials: methodologic issues. Control Clin Trials. 1989;10(4 Suppl):195s-208s.
8. Golden DB, Demain J, Freeman T, Graft D, Tankersley M, Tracy J, et al. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28-54.
9. Bilò BM, Bonifazi F. Epidemiology of insect-venom anaphylaxis. Curr Opin Allergy Clin Immunol. 2008;8(4):330-7.
10. Bilò MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Allergy. 2009;39(10):1467-76.
11. Gawlik R, Marcak M, Bożek A. Importance of wasp and honey bee recombinant allergens in the diagnosis of hymenoptera venom anaphylaxis. Alergoprofil 2019, Vol. 15, No. 1, 11-15, DOI: 10.24292/01.AP.151090119.
12. Worm M, Moneret-Vautrin A, Scherer K, Lang R, Fernandez-Rivas M, Cardona V, et al. First European data from the network of severe allergic reactions (NORA). Allergy. 2014;69(10):1397-404.
13. Oude Elberink JN, De Monchy JG, Van Der Heide S, Guyatt GH, Dubois AE. Venom immunotherapy improves health-related quality of life in patients allergic to yellow jacket venom. J Allergy Clin Immunol. 2002;110(1):174-82.
14. Oude Elberink JN, van der Heide S, Guyatt GH, Dubois AE. Analysis of the burden of treatment in patients receiving an EpiPen for yellow jacket anaphylaxis. J Allergy Clin Immunol. 2006;118(3):699-704.
15. Goldberg A, Confino-Cohen R. Insect sting-inflicted systemic reactions: attitudes of patients with insect venom allergy regarding after-sting behavior and proper administration of epinephrine. J Allergy Clin Immunol. 2000;106(6):1184-9.
16. Müller U, Helbling A, Berchtold E. Immunotherapy with honeybee venom and yellow jacket venom is different regarding efficacy and safety. Journal of Allergy and Clinical Immunology. 1992;89(2):529-35.
17. Ruëff F, Vos B, Oude Elberink J, Bender A, Chatelain R, Dugas-Breit S, et al. Predictors of clinical effectiveness of Hymenoptera venom immunotherapy. Clin Exp Allergy. 2014;44(5):736-46.
18. Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilò MB, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018;73(4):744-64.
19. Confino-Cohen R, Melamed S, Goldberg A. Debilitating beliefs and emotional distress in patients given immunotherapy for insect sting allergy: a prospective study. Allergy Asthma Proc. 2009;30(5):546-51.
20. Armisén M, Guspi R, Alfaya T, Cruz S, Fernández S, Domínguez-Noche C, et al. Cross-Sectional Validation of a Quality of Life Questionnaire in Spanish for Patients Allergic to Hymenoptera Venom. J Investig Allergol Clin Immunol. 2015;25(3):176-82.
21. Oude Elberink JN, Dubois AE. Quality of life in insect venom allergic patients. Curr Opin Allergy Clin Immunol. 2003;3(4):287-93.
22. Oude Elberink JN, van der Heide S, Guyatt GH, Dubois AE. Immunotherapy improves health-related quality of life of adult patients with dermal reactions following yellow jacket stings. Clin Exp Allergy. 2009;39(6):883-9.
23. Ghazanfari Z, Niknami S, Ghofranipour F, Hajizadeh E, Montazeri A. Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP). BMC Med Res Methodol. 2010;10:104.
24. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297-334.
25. Höfer V., Martini M., Dölle-Bierke S., Worm M., Bilò, MB. Health-related quality of life in food and venom induced anaphylaxis and role of influencing factors. Clinical & Experimental Allergy, 2022, DOI: 10.1111/cea.14268.
26. Eitel T, Kim Nikola Zeinera KN, Assmusa K, Ackermann H, Zoellera N, Meissner M, Kaufmann R, Kippenberger S, Valesky EM. Impact of specific immunotherapy and sting challenge on the quality of life in patients with hymenoptera venom allergy, 2021, World Allergy Organization Journal, 14:100536, http://doi.org/10.1016/j.waojou.2021.100536.
27. Cichocka-Jarosz E., Brzyski P., Tarczoń I., Jedynak-Wąsowicz, U, Tomasik T, Lis G. Annals of Agricultural and Environmental Medicine 2019, Vol 26, No 2, 315–321.8.
28. Fischer J, Feidt A, Giel KE, Martens U, Zipfel S, Biedermann T, et al. Quality-of-life in wasp venom allergy - validation of the German version of the "Vespid Allergy Quality of Life Questionnaire" (VQLQ-d). J Dtsch Dermatol Ges. 2011;9(5):379-85.
29. Sin BA, Öztuna D, Gelincik A, Gürlek F, Baysan A, Sin AZ, et al. Quality-of-life in insect venom allergy: validation of the Turkish version of the "Vespid Allergy Quality of Life Questionnaire" (VQLQ-T). Springerplus. 2016;5:583.
30. ude Elberink JN, de Monchy JG, Golden DB, Brouwer JL, Guyatt GH, Dubois AE. Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy. J Allergy Clin Immunol. 2002;109(1):162-70.
31. Nowak N, Bazan-Socha S, Pulka G, Pełka K, Latra P. Evaluation of the quality of life in subjects with a history of severe anaphylactic reaction to the Hymenoptera venom. Pneumonol Alergol Pol. 2015;83(5):352-8.
32. Fischer J, Teufel M, Feidt A, Giel KE, Zipfel S, Biedermann T. Tolerated wasp sting challenge improves health-related quality of life in patients allergic to wasp venom. J Allergy Clin Immunol. 2013;132(2):489-90.
33. Cichocka-Jarosz E, Brzyski P, Swiebocka E, Lange J, Tobiasz-Adamczyk B, Lis G, et al. Health-related quality of life in Polish adolescents with Hymenoptera venom allergy treated with venom immunotherapy. Arch Med Sci. 2012;8(6):1076-82.
34. Koschel DS, Schmies M, Weber CN, Höffken G, Balck F. Tolerated sting challenge in patients on Hymenoptera venom immunotherapy improves health-related quality of life. J Investig Allergol Clin Immunol. 2014;24(4):226-30.
35. Silva D, Pereira AM, Santos N, Amaral L, Delgado L, Oude Elberink JN, et al. The Vespid Allergy Quality of Life Questionnaire - cultural adaptation and translation to Portuguese. Eur Ann Allergy Clin Immunol. 2017;49(3):114-21.
36. Hockenhull J, Elremeli M, Cherry MG, Mahon J, Lai M, Darroch J, et al. A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy. Health Technol Assess. 2012;16(12):Iii-iv, 1-110.
37. Boyle RJ, Dickson R, Hockenhull J, Cherry MG, Elremeli M. Immunotherapy for Hymenoptera venom allergy: too expensive for European health care? Allergy. 2013;68(10):1341-2.
2. Voll-Aanerud M, Eagan TML, Wentzel-Larsen T, Gulsvik A, Bakke PS. Asthma and health-related quality of life – effect of adjusting for potential confounders. The Clinical Respiratory Journal. 2008;2(2):106-15.
3. Leynaert B, Neukirch C, Liard R, Bousquet J, Neukirch F. Quality of life in allergic rhinitis and asthma. A population-based study of young adults. Am J Respir Crit Care Med. 2000;162(4 Pt 1):1391-6.
4. van der Velde JL, Dubois AE, Flokstra-de Blok BM. Food allergy and quality of life: what have we learned? Curr Allergy Asthma Rep. 2013;13(6):651-61.
5. Zuberbier T, Lötvall J, Simoens S, Subramanian SV, Church MK. Economic burden of inadequate management of allergic diseases in the European Union: a GA(2) LEN review. Allergy. 2014;69(10):1275-9.
6. Guyatt GH, Feeny DH, Patrick DL. Measuring health-related quality of life. Ann Intern Med. 1993;118(8):622-9.
7. Aaronson NK. Quality of life assessment in clinical trials: methodologic issues. Control Clin Trials. 1989;10(4 Suppl):195s-208s.
8. Golden DB, Demain J, Freeman T, Graft D, Tankersley M, Tracy J, et al. Stinging insect hypersensitivity: A practice parameter update 2016. Ann Allergy Asthma Immunol. 2017;118(1):28-54.
9. Bilò BM, Bonifazi F. Epidemiology of insect-venom anaphylaxis. Curr Opin Allergy Clin Immunol. 2008;8(4):330-7.
10. Bilò MB, Bonifazi F. The natural history and epidemiology of insect venom allergy: clinical implications. Clin Exp Allergy. 2009;39(10):1467-76.
11. Gawlik R, Marcak M, Bożek A. Importance of wasp and honey bee recombinant allergens in the diagnosis of hymenoptera venom anaphylaxis. Alergoprofil 2019, Vol. 15, No. 1, 11-15, DOI: 10.24292/01.AP.151090119.
12. Worm M, Moneret-Vautrin A, Scherer K, Lang R, Fernandez-Rivas M, Cardona V, et al. First European data from the network of severe allergic reactions (NORA). Allergy. 2014;69(10):1397-404.
13. Oude Elberink JN, De Monchy JG, Van Der Heide S, Guyatt GH, Dubois AE. Venom immunotherapy improves health-related quality of life in patients allergic to yellow jacket venom. J Allergy Clin Immunol. 2002;110(1):174-82.
14. Oude Elberink JN, van der Heide S, Guyatt GH, Dubois AE. Analysis of the burden of treatment in patients receiving an EpiPen for yellow jacket anaphylaxis. J Allergy Clin Immunol. 2006;118(3):699-704.
15. Goldberg A, Confino-Cohen R. Insect sting-inflicted systemic reactions: attitudes of patients with insect venom allergy regarding after-sting behavior and proper administration of epinephrine. J Allergy Clin Immunol. 2000;106(6):1184-9.
16. Müller U, Helbling A, Berchtold E. Immunotherapy with honeybee venom and yellow jacket venom is different regarding efficacy and safety. Journal of Allergy and Clinical Immunology. 1992;89(2):529-35.
17. Ruëff F, Vos B, Oude Elberink J, Bender A, Chatelain R, Dugas-Breit S, et al. Predictors of clinical effectiveness of Hymenoptera venom immunotherapy. Clin Exp Allergy. 2014;44(5):736-46.
18. Sturm GJ, Varga EM, Roberts G, Mosbech H, Bilò MB, Akdis CA, et al. EAACI guidelines on allergen immunotherapy: Hymenoptera venom allergy. Allergy. 2018;73(4):744-64.
19. Confino-Cohen R, Melamed S, Goldberg A. Debilitating beliefs and emotional distress in patients given immunotherapy for insect sting allergy: a prospective study. Allergy Asthma Proc. 2009;30(5):546-51.
20. Armisén M, Guspi R, Alfaya T, Cruz S, Fernández S, Domínguez-Noche C, et al. Cross-Sectional Validation of a Quality of Life Questionnaire in Spanish for Patients Allergic to Hymenoptera Venom. J Investig Allergol Clin Immunol. 2015;25(3):176-82.
21. Oude Elberink JN, Dubois AE. Quality of life in insect venom allergic patients. Curr Opin Allergy Clin Immunol. 2003;3(4):287-93.
22. Oude Elberink JN, van der Heide S, Guyatt GH, Dubois AE. Immunotherapy improves health-related quality of life of adult patients with dermal reactions following yellow jacket stings. Clin Exp Allergy. 2009;39(6):883-9.
23. Ghazanfari Z, Niknami S, Ghofranipour F, Hajizadeh E, Montazeri A. Development and psychometric properties of a belief-based Physical Activity Questionnaire for Diabetic Patients (PAQ-DP). BMC Med Res Methodol. 2010;10:104.
24. Cronbach LJ. Coefficient alpha and the internal structure of tests. Psychometrika. 1951;16(3):297-334.
25. Höfer V., Martini M., Dölle-Bierke S., Worm M., Bilò, MB. Health-related quality of life in food and venom induced anaphylaxis and role of influencing factors. Clinical & Experimental Allergy, 2022, DOI: 10.1111/cea.14268.
26. Eitel T, Kim Nikola Zeinera KN, Assmusa K, Ackermann H, Zoellera N, Meissner M, Kaufmann R, Kippenberger S, Valesky EM. Impact of specific immunotherapy and sting challenge on the quality of life in patients with hymenoptera venom allergy, 2021, World Allergy Organization Journal, 14:100536, http://doi.org/10.1016/j.waojou.2021.100536.
27. Cichocka-Jarosz E., Brzyski P., Tarczoń I., Jedynak-Wąsowicz, U, Tomasik T, Lis G. Annals of Agricultural and Environmental Medicine 2019, Vol 26, No 2, 315–321.8.
28. Fischer J, Feidt A, Giel KE, Martens U, Zipfel S, Biedermann T, et al. Quality-of-life in wasp venom allergy - validation of the German version of the "Vespid Allergy Quality of Life Questionnaire" (VQLQ-d). J Dtsch Dermatol Ges. 2011;9(5):379-85.
29. Sin BA, Öztuna D, Gelincik A, Gürlek F, Baysan A, Sin AZ, et al. Quality-of-life in insect venom allergy: validation of the Turkish version of the "Vespid Allergy Quality of Life Questionnaire" (VQLQ-T). Springerplus. 2016;5:583.
30. ude Elberink JN, de Monchy JG, Golden DB, Brouwer JL, Guyatt GH, Dubois AE. Development and validation of a health-related quality-of-life questionnaire in patients with yellow jacket allergy. J Allergy Clin Immunol. 2002;109(1):162-70.
31. Nowak N, Bazan-Socha S, Pulka G, Pełka K, Latra P. Evaluation of the quality of life in subjects with a history of severe anaphylactic reaction to the Hymenoptera venom. Pneumonol Alergol Pol. 2015;83(5):352-8.
32. Fischer J, Teufel M, Feidt A, Giel KE, Zipfel S, Biedermann T. Tolerated wasp sting challenge improves health-related quality of life in patients allergic to wasp venom. J Allergy Clin Immunol. 2013;132(2):489-90.
33. Cichocka-Jarosz E, Brzyski P, Swiebocka E, Lange J, Tobiasz-Adamczyk B, Lis G, et al. Health-related quality of life in Polish adolescents with Hymenoptera venom allergy treated with venom immunotherapy. Arch Med Sci. 2012;8(6):1076-82.
34. Koschel DS, Schmies M, Weber CN, Höffken G, Balck F. Tolerated sting challenge in patients on Hymenoptera venom immunotherapy improves health-related quality of life. J Investig Allergol Clin Immunol. 2014;24(4):226-30.
35. Silva D, Pereira AM, Santos N, Amaral L, Delgado L, Oude Elberink JN, et al. The Vespid Allergy Quality of Life Questionnaire - cultural adaptation and translation to Portuguese. Eur Ann Allergy Clin Immunol. 2017;49(3):114-21.
36. Hockenhull J, Elremeli M, Cherry MG, Mahon J, Lai M, Darroch J, et al. A systematic review of the clinical effectiveness and cost-effectiveness of Pharmalgen® for the treatment of bee and wasp venom allergy. Health Technol Assess. 2012;16(12):Iii-iv, 1-110.
37. Boyle RJ, Dickson R, Hockenhull J, Cherry MG, Elremeli M. Immunotherapy for Hymenoptera venom allergy: too expensive for European health care? Allergy. 2013;68(10):1341-2.
| Files | ||
| Issue | Vol 23 No 1 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijaai.v23i1.14954 | |
| Keywords | ||
| Allergy quality of life Anaphylaxis Hymenoptera Hymenoptera venom Quality of life | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Bemaniyan MH, Heidari M, Tavakol M, Nabavi M, Ramezani Kashal F, Gholami M, Bemaniyan B. A Quality-of-life Study in Patients with Anaphylaxis to Hymenoptera Venom in Iran. Iran J Allergy Asthma Immunol. 2024;23(1):59-68.
