Prescription of adrenaline auto-injectors for potential anaphylaxis—a population survey

Abstract

Objective. To assess the quality of training provided to parents of children prescribed adrenaline auto-injector devices, adherence to the Chief Medical Officer's recommendation regarding specialist referral, and effect of allergies on quality of life. Setting. Middlesbrough, Redcar and Cleveland districts in North-east England. Design. Postal questionnaire to parents of all children prescribed an auto-injector in the area ( n=154). Results. One hundred and seven parents replied. General practitioners were the source of initial prescription for 30 children. Fifty-one children were not referred to a specialist allergy clinic. Four parents said that they had received no training in the use of the device. Dummy auto-injectors were not used to train 51 parents. Forty-six families were not given the opportunity to retrain. Eleven parents had low or very low confidence in the use of the device, and 13 parents were unsure when to use it. Quality of life was significantly affected. Sixteen children were bullied as a result of their allergy. Thirty parents felt that their child could not do something they really enjoyed as a result of the allergy, and 39 parents felt that their own lifestyle was affected. Conclusion. The impact of the prescription of auto-injector devices should not be underestimated. National guidelines regarding specialist referral were often not followed, and this needs to be addressed by primary care organizations. Quality of training issues needed to be addressed and this has led to re-organization of services in our district.