Evaluating the Need for Pre-CoMiSS™, a Parent-Specific Cow’s Milk-Related Symptom Score: A Qualitative Study

Background/Objectives: Cow&rsquo:s milk allergy (CMA) presents a significant clinical burden. The Cow&rsquo:s Milk-related Symptom Score (CoMiSS&trade:) is a widely used clinical screening tool designed to raise awareness of CMA among healthcare professionals. This qualitative study aimed to assess the need for a parent-reported CoMiSS&trade: tool (Pre-CoMiSS&trade:) and explore its potential usefulness for parents and primary care physicians (PCPs). Methods: Participants were parents of infants aged 2&ndash:12 months and PCPs from Germany, Sweden, Spain, and the United Kingdom (UK) selected from a local panel of potential respondents. Interviews, conducted by experienced qualitative research moderators, consisted of pre-decided standardised questions. Thematic analysis was undertaken, and themes were derived from the data. Results: A total of 26 parent interviews and 18 primary care physician interviews were conducted. Parents from all countries found the Pre-CoMiSS&trade: tool helpful for understanding their baby&rsquo:s signs, easy to use, and useful for facilitating consultation with the physician. Physicians in the UK, Spain, and Sweden found that the Pre-CoMiSS&trade: tool was helpful for improving symptom reporting and for medical consultations: however, in Germany, physicians had mixed opinions, expressing concerns that the tool might increase parental anxiety, lead to overdiagnosis of CMA, and add to their workload. Conclusions: A parent-specific tool for recording cow&rsquo:s milk-related symptoms was generally well received by parents and most physicians, though concerns about parental anxiety and workload were noted, particularly in Germany. With further validation and refinement, Pre-CoMiSS&trade: may be a useful tool for parents to record their infant&rsquo:s symptoms related to feeding and support PCPs in considering CMA in these infants.