Coping Strategies as Predictors of Stress and Anxiety in Caregivers of Patients with Severe Drug Allergy - European Medical Journal

Coping Strategies as Predictors of Stress and Anxiety in Caregivers of Patients with Severe Drug Allergy

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Derm 8.1 feature image
*Vesna Grivcheva-Panovska,1 Elizabet Miceva-Velichkoska2

The authors have declared no conflicts of interest.

EMJ Dermatol. ;8[1]:48-49. Abstract Review No. AR3.
Anxiety, coping strategy, severe drug allergy, stress.

Each article is made available under the terms of the Creative Commons Attribution-Non Commercial 4.0 License.


The unpredictability and fear of potentially life-threatening allergic reactions influences the occurrence and manifestation of anxiety in patients with severe drug allergy, as well as their family members.1 Allergic reactions can range from mild, with local symptoms, to severe, with the most extreme being anaphylactic shock.2 Anxiety limits psychosocial functioning and has a strong impact on quality of life. Most mental health recommendations are focussed on patients,3 however, it is frequently overlooked that their family members and caregivers are also affected.


A total of 21 family members and caregivers of patients with severe drug allergy who had been diagnosed <6 months prior to the start of the study (Group A1), and 97 family members and caregivers of patients that were diagnosed >6 months prior to the study (Group A2), were included. Group B1 (control) included 22 family members of patients with severe food allergy (manifesting with adverse events) diagnosed <6 months prior to the study and 92 family members of patients diagnosed >6 months prior (Group B2). All participants underwent semi-structured interviews using the Ways of Coping Questionnaire (WCQ) and the Hamilton Anxiety Rating Scale (HAMA), specialised for the purpose of the study.


The least frequently used strategies for coping in Group A2 were distancing (14%), confrontation (11%), and avoidance (13%). However, in Group A1, confrontation was more pronounced (53%), especially during the initial phase of facing with the diagnosis. The most common strategies in Group A2 were planned problem solving, seeking social support, and positive evaluation of the state.

A high level of anxiety was diagnosed in Group A1, which, along with coping strategies, was found to have interfered with quality of life.

The most frequent coping strategy in Group B1 was confrontation (42%), followed by distancing and isolation. The most frequently used approachs in Group B2 were problem-solving coping strategies and a positive attitude and evaluation of the state. The general major concerns, as demonstrated in the results of the targeted seven-item questionnaire, were unpredictability of severe drug allergy and delayed access to urgent medical care. The general major concern of partners was the possibility of a lethal outcome; in contrast, the parents’ major concern was having access to a treatment centre where their child could receive adequate treatment in a timely manner.


Participants with a functional, positive, and proactive coping style had a reduced level of stress and anxiety related to the disease and therapy. Adherence to healthcare professional’s advice was higher and there was a positive effect on the patient’s overall health and quality of life. Although patients with severe drug allergy are independent, fully functional members of society, caregivers and family members must not be overlooked when considering comprehensive care. Understanding the complex impact severe drug allergy has on everyday life might also offer ideas for additional therapeutic approaches, both for patients with severe drug allergy and their caregivers.

Schatz M et al. Controversies in drug allergy: consensus documents from the world experts. J Allergy Clin Immunol Pract. 2019;7(1):66-7. Sánchez-Borges M et al. World Allergy Organization grading system for systemic allergic reactions: it is time to speak the same language when it comes to allergic reactions. Curr Treat Options Allergy. 2019;6(4):388-95. Losappio LM et al. Anxiety and depression effects during drug provocation test. J Allergy Clin Immunol Pract. 2018;6(5):1637-41.

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