Division of Health Behavior Research, Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, California.
Department of Community Health, Tufts University School of Arts and Sciences, Medford, Massachusetts.
Ann Allergy Asthma Immunol. 2018 Oct;121(4):479-489.e2. doi: 10.1016/j.anai.2018.06.010. Epub 2018 Jun 21.
Previous studies have suggested that epinephrine auto-injector (EAI) carriage and emergency use practices could be suboptimal for patients prescribed these devices for anaphylaxis management.
To characterize EAI prescription fill rates, carriage, and use practices and associated factors and perceived barriers to recommended anaphylaxis management behaviors in US children, adolescents, and adults.
Survey data were collected for adults (n = 450) and parents of children (n = 255) and adolescents (n = 212) who had been prescribed an EAI. Of eligible participants, survey completion rates were higher than 90%. A multiple-group structural equation model was fit to test adjusted associations.
Most patients (89%) filled their EAI prescriptions; however, of those who did not, the most commonly cited barriers to filling prescriptions were no history of reactions (26%) and EAI cost (25%). Forty-four percent carried at least 1 EAI "all the time" and 24% carried multiple EAIs. Sixty-five percent of respondents reported a personal history of EAI use. Most adults (52%) reported that an EAI was not used, although it would have been beneficial during their most severe allergic reaction. The most frequently given reasons for not using an EAI among respondents owning one were that an EAI was not available (45%) followed by their allergy was undiagnosed at the time (35%). To improve clinical anaphylaxis management, 61% of patients desired more effective patient education and 47% desired more time dedicated to patient education during the physician visit.
These data suggest that current anaphylaxis management practices are suboptimal but could be facilitated through lowering EAI-related out-of-pocket costs and improving patient education efforts.
先前的研究表明，对于接受肾上腺素自动注射器（EAI）治疗的患者，其 EAI 携带和紧急使用实践可能并不理想。
描述美国儿童、青少年和成年人 EAI 处方填写率、携带和使用实践以及相关因素，以及推荐的过敏管理行为的感知障碍和障碍。
对成年人（n=450）和儿童（n=255）和青少年（n=212）父母的调查数据进行了收集，这些患者曾被处方 EAI。在合格的参与者中，调查完成率高于 90%。拟合了一个多组结构方程模型来测试调整后的关联。
大多数患者（89%）都填写了 EAI 处方；但是，未填写处方的患者最常提到的处方填写障碍是没有过敏反应史（26%）和 EAI 费用（25%）。44%的人始终携带至少 1 个 EAI，24%的人携带多个 EAI。65%的受访者报告个人使用过 EAI。尽管在最严重的过敏反应期间可能会受益，但大多数成年人（52%）表示未使用 EAI。在拥有 EAI 的受访者中，最常未使用 EAI 的原因是 EAI 不可用（45%），其次是当时过敏未确诊（35%）。为了改善临床过敏管理，61%的患者希望获得更有效的患者教育，47%的患者希望在医生就诊期间更多地投入时间进行患者教育。
这些数据表明，目前的过敏管理实践并不理想，但可以通过降低 EAI 相关自付费用和加强患者教育来促进。
