PO-1023 Over-prescription Of Adrenaline Auto-injectors In School Age Children?

Abstract

Anaphylaxis is an acute, potentially life-threatening condition. Referral to specialist allergy services is vital to allow identification of triggers involved. One of the key purposes of these clinics is prescription of rescue medication, which can include adrenaline auto-injectors. Aim We reviewed all patients who attended the Paediatric Allergy Clinic and were supplied with an adrenaline auto-injector over the period of January 2008–December 2013. We aimed to compare this number with the number of children with anaphylaxis care-plans in schools within the Northern Health and Social care trust. Method We reviewed all submissions to the Adrenaline Auto-injector log-book. This is held at the Paediatric Allergy Clinic and completed each time a patient is seen who has been prescribed an adrenaline auto-injector. Information was obtained from the Public Health nursing team to ascertain the number of children with an anaphylaxis care-plan for school. Results In 2013 there were 49,286 children aged between 5–16 years within the NHSCT; 580 children were identified with an anaphylaxis care-plan held in school. Prevalence of school aged children at risk of anaphylaxis was 1.2%. Only 160 children (from birth to 18 years), with adrenaline auto-injector devices were reviewed at the allergy clinic in 2013, with 157 reviewed in 2012. Between January 2008 and December 2013 there was six fold increase in patients seen at the Paediatric Allergy Clinic. We reviewed a total of 476 submissions to the Adrenaline Auto-injector logbook; 339 new patients and 137 review patients. There were no specific trends identified with regard to gender but there was a majority of patients under 5 yrs. There was a predominance of nut allergy in the new and review patients. Of the 68 new patients identified with an egg allergy 18% had a sole egg allergy, all of who had been prescribed an adrenaline auto-injector. Conclusion There is a major shortfall with regard to the total number of children within the Northern HSCT who have been prescribed an adrenaline auto-injector and those who are seen at the Paediatric Allergy Clinic. This study has focused future efforts to review each of these patients in a formal paediatric allergy setting.