Design validation and labeling comprehension study for a new epinephrine autoinjector.

BACKGROUND To facilitate the correct use of epinephrine autoinjectors (EAIs) by patients and caregivers, a novel EAI (Auvi-Q) was designed to help minimize use-related hazards. OBJECTIVE To support validation of Auvi-Q final design and assess whether the instructions for use in the patient information leaflet (PIL) are effective in training participants on proper use of Auvi-Q. METHODS Healthy participants, 20 adult and 20 pediatric, were assessed for their ability to complete a simulated injection by following the Auvi-Q instructions for use. Participants relied only on the contents of the PIL and other labeling features (device labeling and its instructions for use, electronic voice instructions and visual prompts). RESULTS The mean ± SD age of the adult and pediatric participants was 39.4 ± 11.6 and 10.9 ± 2.3 years, respectively. In total, 80% of adult and 35% of pediatric participants had prior experience with EAIs. All adults and 95% of pediatric participants completed a simulated injection on the first attempt; 1 pediatric participant required parental training and a second attempt. Three adult and 4 pediatric participants exhibited a noncritical issue while successfully completing the simulated injection. Most participants agreed that the injection steps were easy to follow and the PIL facilitated understanding on using Auvi-Q safely and effectively. CONCLUSION The PIL and other labeling features were effective in communicating instructions for successful use of Auvi-Q. This study provided validation support for the final design and anticipated instructions for use of Auvi-Q.

[1]  Sunday Clark,et al.  Voluntarily reported unintentional injections from epinephrine auto-injectors. , 2010, The Journal of allergy and clinical immunology.

[2]  M. Blanca,et al.  Role of minor determinants of amoxicillin in the diagnosis of immediate allergic reactions to amoxicillin , 2010, Allergy.

[3]  Sam Mehr,et al.  Doctor--how do I use my EpiPen? , 2006, Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology.

[4]  S. Spector,et al.  The diagnosis and management of anaphylaxis practice parameter: 2010 update. , 2010, The Journal of allergy and clinical immunology.

[5]  Stephanie Guerlain,et al.  A comparison of 4 epinephrine autoinjector delivery systems: usability and patient preference. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[6]  A. Sheikh,et al.  World Allergy Organization anaphylaxis guidelines: summary. , 2011, The Journal of allergy and clinical immunology.

[7]  C. Roifman,et al.  Anaphylaxis and epinephrine auto-injector training: who will teach the teachers? , 1999, The Journal of allergy and clinical immunology.

[8]  F. Simons,et al.  Anaphylaxis: evidence-based long-term risk reduction in the community. , 2007, Immunology and allergy clinics of North America.

[9]  A. Ackaoui Treatment of anaphylaxis: EpiPen, Twinject, or another autoinjector? , 2011, Canadian family physician Medecin de famille canadien.

[10]  F. Simons,et al.  Hazards of unintentional injection of epinephrine from autoinjectors: a systematic review. , 2009, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[11]  A. Frew,et al.  What are the ‘ideal’ features of an adrenaline (epinephrine) auto‐injector in the treatment of anaphylaxis? , 2011, Allergy.

[12]  Michael G. Millin,et al.  The Use of Epinephrine for Out-of-Hospital Treatment of Anaphylaxis: Resource Document for the National Association of EMS Physicians Position Statement , 2011, Prehospital emergency care : official journal of the National Association of EMS Physicians and the National Association of State EMS Directors.

[13]  F. Simons,et al.  Epinephrine and its use in anaphylaxis: current issues , 2010, Current opinion in allergy and clinical immunology.

[14]  Stephanie Guerlain,et al.  Intelliject's novel epinephrine autoinjector: sharps injury prevention validation and comparable analysis with EpiPen and Twinject. , 2010, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.