PRS39 - Weaknesses Of Treatment Guidelines For The Management Of Anaphylaxis And Health Care Utilization Following An Anaphylaxis Event

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A prospective, web-based survey was conducted to obtain insight into adherence to treatment guidelines, causes for injection problems using an epinephrine auto-injector (EAI), and post-injection behavior in patients at risk for anaphylaxis and their caregivers. 159 patients aged 18-65 years (Mean =29.7; 32.1% male) and 215 caregivers of individuals under aged 18 years (Mean = 23.3; 39.5% male) participated in the survey. All participants had been prescribed an EAI for self-administration or as a caregiver. The survey took place between November 15 and November 30, 2015. Despite treatment guidelines recommending patients at risk for anaphylaxis have two EAIs prescribed, at home 18.2% of patients and 15.4% of caregivers had no EAI and 61.0% of patients and 62.8% of caregivers indicated one EAI was available. At their workplace 83.0% of patients did not have access to at least one EAI and 35.8% of caregivers reported that their child did not have access to at least one EAI at school. Only 8.0% of caregivers identified that two EAIs were available for their children at school. Of those who received emergency care 5.9% received their first dose of epinephrine in the Emergency Department. 3.0% of patients reported having to call emergency services due to the lack of a secondary EAI with 2.0% being admitted to inpatient care. Following utilization of an EAI, 13.0% of patients and 15.0% of caregivers did not seek follow up medical attention. Given the lifesaving ability of EAIs, the effect of treatment according to guidelines to achieve best patient and caregiver adherence is imperative to successful management of anaphylactic events. The survey results revealed suboptimal adherence to treatment guidelines. The findings of this survey call into question the efficacy of current educational programs and safety information delivered to patients and caregivers regarding the use of EAIs to treat anaphylaxis.