A Real-Life Study on Acquired Skills from Using an Adrenaline Autoinjector

Background: Training programs performed by allergists have increased the ability of patients’ recognition and management of anaphylaxis. We aim to investigate the permanence of effect of an anaphylaxis training program and to determine the factors affecting it beyond training given by allergists. Methods: Children and/or their caregivers who had been prescribed an adrenaline autoinjector at least 1 year before were invited to take part in the study. The knowledge about anaphylaxis was assessed using a questionnaire and the skills were practically tested. Results: Sixty-four (50 caregivers/14 children >12 years of age) of 80 patients who accepted the invitation were included in the study. Fifty-nine patients obtained the autoinjector after initial prescription. Among them, 42 (71%) still had the device at the time of the study. The most common reason for not having the autoinjector was no longer feeling it was necessary (54.6%). Of the cases, 39.4% were competent in autoinjector use. There was a significant relation between adrenaline autoinjector competency and regular allergy visits (p = 0.010), believing that it is necessary (p = 0.04), having an adrenaline autoinjector (p = 0.003), and previous history of severe anaphylaxis (p = 0.010). Autoinjector competency score decreased as time elapsed from the last visit (rho = –0.382; p = 0.002) and the first instruction (rho = –0.317; p = 0.01). Regular visits (p = 0.009) and history of severe anaphylaxis (p = 0.007) were found as independent factors having an effect on adrenaline autoinjector competency. Conclusions: Training of patients/caregivers by allergists does not guarantee the permanence of acquired skills on anaphylaxis in the long run. Regular follow-up visits should be fostered.

[1]  G. Toit,et al.  The use of adrenaline autoinjectors by children and teenagers , 2012, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[2]  M. W. Yocum,et al.  Assessment of patients who have experienced anaphylaxis: a 3-year survey. , 1994, Mayo Clinic proceedings.

[3]  A. Sheikh,et al.  Epinephrine auto‐injector use in adolescents at risk of anaphylaxis: a qualitative study in Scotland, UK , 2011, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[4]  S. Sicherer,et al.  Use assessment of self-administered epinephrine among food-allergic children and pediatricians. , 2000, Pediatrics.

[5]  H. Sampson,et al.  Fatalities due to anaphylactic reactions to foods. , 2001, The Journal of allergy and clinical immunology.

[6]  P. Arkwright,et al.  Factors determining the ability of parents to effectively administer intramuscular adrenaline to food allergic children , 2006, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[7]  R. Sainsbury,et al.  First aid anaphylaxis management in children who were prescribed an epinephrine autoinjector device (EpiPen). , 2000, The Journal of allergy and clinical immunology.

[8]  B. Niggemann,et al.  The management of anaphylaxis in childhood: position paper of the European academy of allergology and clinical immunology , 2007, Allergy.

[9]  D. Hepner,et al.  Second symposium on the definition and management of anaphylaxis: summary report--Second National Institute of Allergy and Infectious Disease/Food Allergy and Anaphylaxis Network symposium. , 2006, The Journal of allergy and clinical immunology.

[10]  J. Sinacore,et al.  Parental use of EpiPen for children with food allergies. , 2005, The Journal of allergy and clinical immunology.

[11]  D. Schroeder,et al.  Epidemiology of anaphylaxis in Olmsted County: A population-based study. , 1999, The Journal of allergy and clinical immunology.

[12]  G. Roberts,et al.  Influence of a multidisciplinary paediatric allergy clinic on parental knowledge and rate of subsequent allergic reactions , 2004, Allergy.