Allergy patients need more education in recognizing, treating anaphylaxis
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Key takeaways:
- 23.7% of respondents said they would first use antihistamines for anaphylaxis.
- The top barrier to epinephrine use was not knowing which symptoms to treat.
BOSTON — There is a need for more education in recognizing anaphylaxis among patients with allergies, according to an abstract presented at the American College of Allergy, Asthma & Immunology Annual Scientific Meeting.
“Early identification of anaphylaxis and early intervention with epinephrine are critical for improving patient outcomes,” Joni Chow, DO, pediatric resident at Baylor College of Medicine and The Children’s Hospital of San Antonio, told Healio. “Many allergic reactions occur in community settings, where written action plans serve to instruct patients and caregivers on how to recognize and respond to these emergencies.”
Chow said that current anaphylaxis action plans are limited in terms of the information available on the preferences of patients and caregivers.
“We have observed that, even with the implementation of current action plans, a notable number of patients and families struggle to recognize and manage severe allergic reactions effectively,” she said. “In response to this issue, we have created a survey designed to assess the understanding of anaphylaxis recognition and management among patients and caregivers, while also identifying their preferences regarding the elements included in the action plans.”
The survey assessed a patient’s knowledge of anaphylaxis and what they wish to see in an anaphylaxis action plan. In total, 96 patients/caregivers completed the survey in an allergy clinic waiting room.
Among the 96 respondents, 95.8% were prescribed epinephrine and 73% said they felt comfortable recognizing anaphylaxis symptoms. Only 14% identified symptoms that required the use of epinephrine correctly.
During an anaphylactic episode, 23.7% of respondents said they would first treat it with an antihistamine, although 85% reported that antihistamines do not replace the need for epinephrine. In the scenario where rash and wheezing are present after an allergen exposure, 64.5% said they would use epinephrine and 10.8% said they would first go to the ED.
The most common barriers to epinephrine usage were not being sure which symptoms to treat (40.6%), not being sure how to use epinephrine autoinjectors (11.5%), a fear of needles (5.2%), hesitancy to call 911 (17.7%) and hesitancy to go to the ED (24%).
Only 36.5% of respondents had an anaphylaxis action plan. What respondents most wanted to see in their action plan were points targeting the management of mild or non-anaphylactic allergic reaction symptoms (93%), visual aids on how to properly inject epinephrine (87.6%) and visual aids that show anaphylaxis symptoms (81%).
“These findings were unexpected, as fear of needles is considered a significant deterrent to epinephrine use,” Chow said. “However, our respondents were more inclined to acknowledge a reluctance to escalate to emergency response as the major barrier to treatment.”
Chow emphasized that study results show the importance of educating allergy patients on recognizing and treating anaphylaxis and that visual aids are preferred.
“Most patients and caregivers from our surveyed population report knowing how to treat anaphylaxis, but many would not use epinephrine as the first treatment,” she said. “While they understand that antihistamines don’t prevent the need for epinephrine, many administer antihistamines first in anaphylactic reactions.”