This article is more than 5 years old. Information may no longer be current.

Low number of physicians providing epinephrine instructions to parents

Parents of children with allergies reported that although the quality of their health care was high, many physicians had not taught them when to use epinephrine or provided an emergency health care plan, according to recent research.

“Although physicians may follow guidelines for the management of chronic conditions, families may not receive the message,” Ruchi S. Gupta, MD, MPH, of Northwestern University Feinberg School of Medicine, Chicago, and colleagues wrote. “The concept of teach-back, asking patients to restate the information presented, has been emphasized in clinical settings to improve patient comprehension and recall of messages from their clinicians.”

Ruchi S. Gupta

Through Children’s Memorial Hospital Food Allergy Questionnaire and a structured interview, the researchers analyzed 859 families with at least one child who had a food allergy and asked them about their satisfaction with care. The most common food allergy studied was a peanut allergy (47% of patients), followed by patients with milk allergy (38%), egg allergy (29%) and tree nut allergies (19%).

Gupta and colleagues found that patients had a high satisfaction rate for their health care, feeling their pediatrician (97%) or allergist (93%) treated them with courtesy and respect. Parents felt their pediatrician (96%) and allergist (93%) listened to questions and concerns and that their pediatrician (89%) and allergist (92%) listened to concerns about their child’s food allergy. Further, they felt pediatricians (75%) and allergists (95%) explained food allergy in an easy to understand way while also showing concern for the effect food allergy had on the family unit (pediatricians, 76%; allergists, 83%).

However, only 68% of allergists and 37% of pediatricians taught parents when to use epinephrine during the 6 months preceding the study, and only 47% of allergists and 20% of pediatricians showed how to use epinephrine. In addition, 56% of allergists and 20% of pediatricians had given parents a written emergency health care plan for their child. Parents also reported 59% of allergists and 26% of pediatricians discussed long-term management plans for a child’s food allergy.

“With our understanding of food allergy and anaphylaxis constantly evolving, guidelines and recommendations for how and when to give epinephrine and the need for an action plan need to be reinforced by physicians,” Gupta and colleagues wrote. – by Jeff Craven

Disclosure: One researcher reports research support from Bunning Family Food Allergy Project, Food Allergy Research and Education, and the National Institute of Allergy and Infectious Diseases.