Despite most adults (89%) filling their epinephrine auto-injector (EAI) prescriptions, over half (52%) report not using their EAI during their most severe reaction. This is mostly due to the injector not being available at the time of their reaction. 

The findings come from new survey developed by a multi-disciplinary team that included health care professionals, food allergy patients, biostatisticians and research coordinators. In total, 917 individuals with EAI prescriptions completed the survey (255 aged 0 to 12 years; 212 aged 13 to 17 years; and 450 aged 18 to 65 years). 

Peanut (30%), shellfish (22%) and milk (21%) were the most commonly reported food allergies among the sample. In the past year, 69% of respondents experienced at least 1 allergic reaction; 39% had multiple reactions. Most adults (52%) reported that an EAI was not used during their most severe reaction, even though it would have been beneficial, 45% said they didn’t have it with them at the time. 

Fifity-eight and 59% of respondents had strong agreement with the statements: “I know the steps to use an EAI”; “I can recognize the signs and symptoms of a severe allergic reaction”; and “I would be able to effectively use an EAI if I had a severe allergic reaction” 

Related Articles

Additionally, responses showed that just 50% of the time the EAI used to treat the individuals most severe reaction was carried by the reacting individual; in 33% of cases the EAI used was provided by medical personnel; in 7% of cases it was prescribed to another individual and in 6% of cases it was provided by an institution (e.g. school or workplace).  

Overall, 51% of respondents had an EAI accessible within 5 minutes ‘all of the time’ and that only 44% carried  at least 1 EAI ‘all the time’. These carriage rates are lower than previous studies (Ben-Shoshan et al 2008, Sampson et al 2006).

The authors of the study write, “Despite recommendations by some experts that patients at risk of anaphylaxis carry multiple EAIs, and the inclusion of multiple EAIs in the packaging of commercially-available devices, fewer than 25% of respondents reported routinely carrying multiple EAIs.” Cost was a barrier cited for not carrying EAIs, with ~70% of the sample reporting that lower EAI costs would increase access while 50% believed that increased access would come from increasing EAI stock availability. 

The researchers concluded that, from their findings, current EAI carriage practices are “suboptimal and may be improved through reducing EAI-related out-of-pocket costs and facilitating patient education efforts aimed at increasing knowledge and self-efficacy regarding how/when to effectively use EAIs.”

For more information visit