How DRACMA changes clinical decision for the individual patient in CMA therapy

Luigi Terracciano, Holger Schünemann, Jan Brozek, Carlo Agostoni, Alessandro Fiocchi

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose of Review: To describe the impact of the diagnosis and rationale for action against cow's milk allergy (DRACMA) guidelines on the decision process in the therapy of cow's milk allergy (CMA). Recent Findings: We report here the experience of a 2-year application of DRACMA worldwide. Variations in the socioeconomic profile of CMA sufferers and their context can modify the application of DRACMA recommendations. As an example, we use the country-by-country modifications of the social structure and the modifications of the prices for special formula in Italy. Summary: The DRACMA guidelines were issued to inform formula choice for CMA treatment by integrating patients' underlying values, preferences and remarks into grading of recommendations assessment, development and evaluation (GRADE) recommendations, which serve to facilitate their interpretation. This method allows every pediatrician/allergist to follow the changing variables of formulas (cost, palatability, nutritional value) and tailor their prescription for individual patients accordingly. The art of CMA treatment has always relied on physicians' interpretation and the goal of the DRACMA guidelines is to provide a rationale-based and evidence-based indication for choosing an appropriate formula.

Original languageEnglish
Pages (from-to)316-322
Number of pages7
JournalCurrent Opinion in Allergy and Clinical Immunology
Volume12
Issue number3
DOIs
Publication statusPublished - Jun 2012

Keywords

  • allergy
  • development and evaluation
  • diagnosis and rationale for action against cow's milk allergy
  • grading of recommendations assessment
  • milk
  • treatment

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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