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Emergency epinephrine use not common among adults with allergies

Only 48% of adults experiencing a severe allergic reaction used an epinephrine auto-injector, according to findings recently published in the Annals of Allergy, Asthma and Immunology.

“With no current widely available curative treatment, allergen avoidance ... and proper anticipatory management of anaphylaxis are essential,” Christopher M. Warren, PhD, department of preventive medicine, University of Southern California Keck School of Medicine, and colleagues wrote.

“It is imperative that we better our understanding of current epinephrine carriage and usage practices in the U.S., including the barriers that may impair patients' ability to routinely carry and — if necessary — self-administer emergency epinephrine in a timely, efficacious manner,” they wrote.

The findings are based on a survey completed by 917 individuals, 467 of whom were responding either for themselves or on behalf of children younger than 18 years. Other findings include:

• 89% filled the prescriptions they were given for an epinephrine auto-injector.
• 78% had been hospitalized for their allergy at some point in their lifetime.
• 45% said they did not have their epinephrine auto-injector with them during their most severe allergic reaction.
• 21% said they did not know how to use their epinephrine auto-injector.

One of the study’s co-authors, Ruchi S. Gupta, MD, Northwestern University Feinberg School of Medicine, discussed ways primary care physicians can help their patients manage their allergies.

Ruchi S. Gupta

“Proper communication between a patient and physician is important. A clinician can set the tone for a patient’s allergic experience. It is crucial to eliminate the narrative of fear when using epinephrine and create one of empowerment. This starts in the primary care physician’s office with thoughtful education about allergies and their acute management,” she told Healio Family Medicine.

“It is also vital to counsel on the importance of habitual access to an [epinephrine auto-injector] and to work with patients to figure out how to incorporate [epinephrine auto-injectors] into their individual lives. Additionally, the joint development of an allergy action plan with a patient and his doctor is a great first step for individuals with allergies.”

Gupta also said the American College of Allergy, Academy and Immunology’s YouTube channel has videos that provide more information for both PCPs and patients on the auto-injector’s management and use.

“Lastly, as a primary care doctor, it is important to refer patients to an allergist. Their experience and expertise in allergy treatment might allow them to offer advice to patients that might not readily come to a primary care clinician.”– by Janel Miller

Disclosures: Warren reports no relevant financial disclosures. Gupta receives grant support from the Allergy and Asthma Network, NIH/NIAID, Melchiorre Family Foundation and Sean N. Parker Center for Allergy & Asthma Research, UnitedHealth Group, Thermo Fisher Scientific, Rho Inc., and Aimmune Therapeutics, and consultant fees from DBV Technologies, Kaleo Inc., and BEFOREBrands. Please see the study for all other relevant financial disclosures.