Universal policy for autoinjectable epinephrine feasible

LOS ANGELES — A universal policy requiring patients to have autoinjectable epinephrine with them while receiving subcutaneous immunotherapy will enhance safety, according to a recent study presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.

“This project stemmed from our experience in a large academic center in which we noticed that approximately one-third of reported systemic reactions from inhalant immunotherapy were delayed onset, with symptoms beginning after the standard 30-minute observation period,” researcher Ahila Subramanian, MD, MPH, of the Cleveland Clinic, told Healio.com/Allergy.

Ahila Subramanian

Subramanian and colleagues conducted a voluntary and anonymous survey for patients receiving SCIT. Using a 5-point Likert scale, the survey prompted questions on demographics and patient satisfaction. One hundred twenty-one surveys were gathered at three sites over the course of two weeks.

Thirty-nine percent of participants (61.9% women; average age, 39 years) were on inhalant immunotherapy. More than half (54.7%) were on maintenance therapy, with the rest (45.3%) on build-up therapy.

According to study results, 85% of respondents agreed or strongly agreed that immunotherapy had been helpful. However, more patients on maintenance agreed (92.2%) vs. patients on build-up (77.4%).

Overall, the majority of participants (72.4%) concurred that having an epinephrine autoinjector accessible in the case of a systemic reaction was well worth the financial cost. This differed in respondents on build-up (84.9%) vs. maintenance (61.9%).

When receiving SCIT, 19.6% of respondents believed that having epinephrine was not vital. The researchers also noted a difference between patients on build-up (13.2%) compared with maintenance (25%).

“Although the overall incidence of systemic reactions with inhalant immunotherapy is low, we felt that implementing a policy requiring patients to have autoinjectable epinephrine with them at the injection visit was an important safeguard in their treatment plan,” Subramanian told Healio.com/Allergy. “A follow-up patient survey one year after implementation demonstrated that the majority of our patients agree with the policy and have complied with the requirements. We have found this is a feasible quality improvement measure to enhance patient safety while maintaining patient satisfaction with inhalant immunotherapy.” — by Alaina Tedesco

Reference: Subramanian A, et al. Abstract 922. Presented at: American Academy of Allergy, Asthma & Immunology Annual Meeting; March 4-7, 2016; Los Angeles.

Disclosure: The researchers report no relevant financial disclosures.