Patients and caregivers believe that needle-free epinephrine delivery would result in a speedier response to treating a severe allergic reaction, according to survey findings presented at the American College of Allergy, Asthma & Immunology (ACAAI) Annual Scientific Meeting, held from November 10 to 14, in Louisville, Kentucky.

Patients and caregivers sometimes hesitate to use an intramuscular epinephrine injectable device after symptom onset. Investigators sought to gain insight into factors affecting the time lapse between severe allergic reaction and administration of epinephrine via an injectable device and triggers for device use.

The researchers conducted a double-blind survey of individuals who had used an epinephrine injectable device within the preceding year. Respondents (100 caregivers and 100 patients) answered questions concerning their allergy (or their child’s allergy), what symptoms triggered their decision to use the injectable device, how much time passed from symptom onset until device use, and what reasons they had for hesitation.

Investigators found 8.8 minutes was the average time from symptom development to device use. The needle was reported as the main delay reason.

Respondents were also asked about their reaction to the concept of a needle-free epinephrine delivery device, if such a device were to be developed. Respondents perceived that such a device would be less painful and easier/less complicated to use. They believed administration without a needle would eliminate needle-related errors (intravenous injection, striking bone). Respondents indicated they would be more inclined to use a needle-free device at the time of symptom onset. Were such device available, estimated time to use would be 4.9 minutes.

As the researchers concluded, “A needle-free option for administering epinephrine would be used more quickly after symptoms developed and would be easier to use versus an injectable device. This underscores the need to develop epinephrine modalities utilizing a non-needle-based delivery system.”


Kaplan H, Rooney E, Tanimoto S, Lowenthal R. Epinephrine via needle-free device would be administered faster after symptoms: results of a patient/caregiver surveyAnn Allergy Asthma Immunol. 2022;125(5):S17.10.1016/j.anai.2022.08.549

This article originally appeared on Pulmonology Advisor.