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

Background/Objectives: Cow's milk allergy (CMA) presents a significant clinical burden. The Cow's Milk-related Symptom Score (CoMiSS (TM)) 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 (TM) tool (Pre-CoMiSS (TM)) and explore its potential usefulness for parents and primary care physicians (PCPs). Methods: Participants were parents of infants aged 2-12 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 (TM) tool helpful for understanding their baby'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 (TM) 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'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 (TM) may be a useful tool for parents to record their infant's symptoms related to feeding and support PCPs in considering CMA in these infants.