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Supervised self-injected epinephrine tutorials improved food-allergic patient, parent comfort levels
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Adolescents with severe food allergies and their parents reported less anxiety about self-administering epinephrine injections after practicing with an empty syringe in a clinical setting, according to a study published in The Journal of Allergy and Clinical Immunology: In Practice.
“Many adolescent patients with food allergies experience needle phobia or anxiety about self-administering epinephrine,” Eyal Shemesh, MD, from the Icahn School of Medicine at Mount Sinai, said in a press release. “Although it’s a simple idea for teenagers to practice giving themselves an injection to make themselves feel comfortable, this could lead to them being confident enough to take a life-saving action using epinephrine down the road.”
In the United States, it is recommended that patients with severe food allergies, asthma or known allergy to potent triggers including peanut, tree nuts, fish or shellfish should be prescribed self-injectable epinephrine; however, teenage patient reluctance to self-inject epinephrine continues to place them at higher risk for fatal food-allergic reactions.
To examine whether supervised self-injection affected the comfort and anxiety levels of both adolescents and parents, Shemesh and colleagues surveyed 60 pairs of teenage patients and their parents, assessing feelings of comfort and anxiety during and after appointments within a food allergy center.
The researchers randomly assigned patient/parent pairs into two groups: self-injection and education only. Participants who reported their comfort level before and after training did so on a Likert scale, with scores ranging from one (not at all comfortable) to 10 (extremely comfortable). The researchers assessed these levels via within group and between group analysis. Quality of life (QoL) and anxiety a month after the intervention were also measured.
According to survey results, significant and immediate increases in comfort levels were observed with the group that practiced self-injection. All other areas of assessment, including QoL and anxiety 1 month after intervention, also demonstrated significant increases. QoL improved for 52% of participants in the self-injection group compared with 25% of participants in the education-only group, and the changes in anxiety were comparable although not statistically significant.
“In other settings, exposure techniques were shown to reduce avoidance behaviors and improve adherence to medical recommendations,” Shemesh and colleagues wrote. “In the food-allergy setting, this may translate into a higher likelihood of using the autoinjector when indicated; epinephrine administered by intramuscular self-injectors is safe and generally well tolerated.”– by Katherine Bortz
Disclosure: S.H. Sicherer is the Associate Editor of JACI: In Practice.
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