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Patients reported low rate of self-injectable epinephrine prior to visiting allergist

LOS ANGELES — Adult and pediatric patients with a food allergy have a lower than ideal rate of having self-injectable epinephrine prior to visiting an allergist, according to recent study data presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

Although underprescription of epinephrine has been previously documented, Todd D. Green, MD, of the division of pulmonary medicine and allergy & immunology at Children's Hospital of Pittsburgh of UPMC and colleagues sought to examine these trends among pediatric and adult food allergy patients.

Todd D. Green

The researchers conducted a retrospective chart review of 74 pediatric and 169 adult patients seen at University of Pittsburgh Medical Center or Children’s Hospital of Pittsburgh of UPMC for a diagnosis of food allergy from June 15, 2004 through June 15, 2014.

Results showed that previous to their first allergy visit, 64% of adults and 58% of children seen by a physician for food allergy had self-injectable epinephrine. Considerably less likely to have epinephrine were adults referred by a primary care physician compared with those seen by another physician (P = .036). A similar trend holds true for children (P = .070). Sixty-two percent of adults and 86% of children who previously treated anaphylaxis with epinephrine had self-injectable epinephrine.

Patients with tree nut allergy were most likely to have epinephrine (children, P = .002; adults; P = .034). Adults with peanut allergy were more likely to have epinephrine (P = .007), whereas adults with fruit allergy were less likely (P = .008). Children with a milk allergy were less likely to have epinephrine (P = .03).

Forty-two percent of the children avoiding three or more foods had epinephrine. Although 66% of children avoiding fewer than three foods had epinephrine (P = .047). This trend was not observed in adults.

“While we were glad to see that many of our patients, particularly those with tree nut allergy and those with a history of epinephrine use, had been appropriately prescribed an epinephrine autoinjector prior to their initial visit to the allergist, it appears that there is still opportunity to improve education around areas such as the safety of epinephrine and the importance of viewing it as the best management for a significant allergic reaction,” Green told Healio.com/Allergy. —by Alaina Tedesco

Reference: Green TD, et al. Abstract 169. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.

Disclosure: The researchers report no relevant financial disclosures.