Physicians show lack of knowledge surrounding diagnosis, treatment of anaphylaxis

Less than half of physicians identified gastrointestinal and upper respiratory tract symptoms as potential signs of anaphylaxis, according to findings presented at the European Academy of Allergy and Clinical Immunology Hybrid Congress.

Further, a greater proportion of residents compared with other physicians correctly identified the proper adrenaline dosage and route of administration to treat anaphylaxis, highlighting the need for continued education regarding anaphylaxis, according to the survey findings.

Cihan Örçen, an allergy and immunology specialist at the Clinic of Chest Diseases at University of Health Sciences, Derince Training and Research Hospital in Kocaeli, Turkey, and colleagues conducted a survey of 840 physicians (men, n = 423) to evaluate their awareness and knowledge of the diagnosis and treatment of anaphylaxis. The physicians represented did not include immunology and allergy specialists; 42% were other specialists, 28.6% were residents, and 29.9% were practitioners.

Overall, 90% of those surveyed recognized cutaneous involvement as a symptom of anaphylaxis, with a slightly smaller proportion recognizing respiratory system (84%) and cardiovascular system (78%) involvement.

However, only 45% recognized gastrointestinal symptom involvement and 23% upper respiratory tract involvement as symptoms of anaphylaxis.

“Anaphylaxis should be considered as a whole with correct diagnosis and correct treatment,” Örçen said in a press release.

Most participants (83.3%) knew adrenaline should be first-line treatment of anaphylaxis, but 48.7% indicated there was no absolute contraindication to its use and 38.9% did not know of any contraindications.

More than half of the physicians identified the correct intramuscular route (69.6%) and the vastus lateralis as the site (76.4%) for adrenaline administration, but only 61% of physicians properly identified the dose. A greater proportion of residents vs. other physicians correctly identified the adrenaline dose (82.2%; P = .001) and route (69.5%; P = .004) for administration, a difference the study researchers attributed to education physicians receive during residency.

Forty-one percent of physicians responded that they knew about the use of autoinjectors, but 93% had never prescribed them.

A lack of recognition among physicians of all the symptoms of anaphylaxis “may explain the inadequate use of adrenaline in the treatment of anaphylaxis in clinical practice,” the researchers wrote.

Moreover, the greater awareness demonstrated by physicians “shows the need for the continuity of the education process to eliminate the lack of knowledge of the physicians in the diagnosis and treatment of anaphylaxis,” they added.

Reference:

• How much are doctors aware of anaphylaxis? What do we know about diagnosis and treatment? https://eaaci-cdn-annual2022-media.azureedge.net/media-library-uploads/11_How_much_are_doctors_aware_of_anaphylaxis_8b357ab040.pdf. Published July 1, 2022. Accessed July 1, 2022.