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 About 40 percent of study participants reported having a severe
allergic reaction when their auto-injector was unavailable.
"Many patients at-risk of potentially life-threatening anaphylaxis
do not routinely carry their prescribed epinephrine auto-injectors,
despite having experienced severe reactions in the past," coauthors
Christopher Warren and Dr. Ruchi Gupta told Reuters Health in a
joint email.
Anaphylaxis can occur within seconds or minutes of exposure to
something a person is allergic to, such as foods, medications, and
insect venom. The immune system releases a flood of chemicals that
cause a sudden drop in blood pressure and trouble breathing, among
other effects.
Epinephrine is the medication of choice for first-aid treatment of
anaphylaxis and is frequently prescribed to allergic patients, said
Warren and Gupta.
"However, previous studies suggest that many individuals at risk of
anaphylaxis often do not have epinephrine auto-injectors on hand
during an allergic episode. We wanted to understand how adults and
children were managing anaphylaxis and if and when they were
carrying and using epinephrine," they said.
Warren (at the University of Southern California Keck School of
Medicine in Los Angeles), Gupta (at Northwestern University Feinberg
School of Medicine in Chicago) and colleagues published their
findings in Annals of Allergy, Asthma and Immunology.
Altogether, the researchers examined survey data covering more than
900 people. In some cases, adult respondents provided information
both for themselves and their child with an epinephrine
auto-injector prescription.
Almost 90 percent of respondents had their auto-injector
prescriptions filled. Among those who didn't, about half said cost
was the reason.
Almost 90 percent of adults and 70 percent of children and teens had
visited a hospital because of an allergic reaction.
Just over half of participants reported their devices could always
be reached within five minutes, and about 44 percent said they
always carried one.
But only about one in three children and teens carried their own
auto-injectors, while parents carried the devices for another third.
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Barriers associated with decreased carriage of the devices "often
fell into two camps: perceptions and procedures," Warren and Gupta
said.
Perception-oriented barriers included a patient's feeling that the
allergy was not severe, or a patient's never having had a previous
reaction, said Warren and Gupta.
On a procedural level, the cost and actual aesthetics of the device
(i.e., believing it's too bulky), or forgetting it, were other
barriers to the habitual carriage, said Warren and Gupta.
Patient education around how and when to use an epinephrine
auto-injector is also important, said Warren and Gupta.
People who knew how and when to effectively use an epinephrine
auto-injector were more likely to report routinely carrying it, as
were patients who felt that their friends and extended family
supported them in the management of their allergy.
"By helping your friends and family members with severe allergies
feel supported in managing their condition, you may increase the
chance that they have potentially life-saving medication on hand
when they need it the most," Warren and Gupta said.
Dr. Merritt Fajt, an immunologist at the University of Pittsburgh in
Pennsylvania who wasn't involved with the study, told Reuters Health
it's important for doctors to make sure patients are comfortable
using auto-injectors.
"I think training . . . is actually very important if you really
want to get people to buy into the whole idea of needing to carry an
EpiPen and being educated at how to use it, and when it's
appropriate to use it," Fajt said.
SOURCE: https://bit.ly/2yR8tQS Annals of Allergy, Asthma and
Immunology, online June 21, 2018.
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