A Cost-Effective Analysis of the U.S. Varicella Zoster Virus (VZV) Vaccination Program with Consideration for Delayed Onset of Asthma Following Vzv Infection

Abstract

M O N D A Y 762 Long-Term Adherence to Self-Injectable Epinephrine Prescription Joyce X.W. Lee, MD, Anil M. Patel, MD, Andrew Q. Pham,MD, Sabrina T. Lee, BS, Jeffrey B. Flores, Joseph S. Yusin, MD, FAAAAI; VA Greater Los Angeles Health Care System, Los Angeles, CA. RATIONALE: Self-injectable Epinephrine (SIE) is essential for immediate treatment of anaphylaxis. Our study aims to determine long-term adherence approximately 10 years after initial SIE prescription. METHODS: A total of 173 patients who received and filled a SIE prescription between 2002 and 2003 at the VAWest Los Angeles Hospital were identified, of which 82 patients were active in the system in 2013. Patient’s gender, race/ethnicity, age, setting of initial SIE prescription, associated diagnosis, and frequency of SIE refills were collected. A prescription for SIE under the active medication list constituted adherence. RESULTS: Of the 82 patients identified, indications for SIE prescription included 36 for venom allergies, 21 for food allergies, 11 for angioedema, 1 for drug allergy, 3 for immunotherapy, and 10 for unknown etiology. Initial SIEwas prescribed at the following clinical sites: 34 from allergy clinic, 40 from primary care clinic, 3 from emergency department, 1 from hospital discharge, and 4 from miscellaneous/unknown clinics. 37 patients (45%) were adherent to SIE prescription with an average of 9 prescription refills over approximately 10 years. 54 patients (55%) were non-adherent to SIE prescription, of which 20 patients (37%) never refilled after their initial prescription. Patients with venom allergies had the highest adherence rate of 62% (23 patients), while those with angioedema had the lowest rate of 27% (3 patients). CONCLUSIONS: This study shows that most patients do not have an active SIE prescription after approximately 10 years, of which 37% patients do not refill after their initial prescription.