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Intern Emerg Med. 2015 Dec;10(8):937-41. doi: 10.1007/s11739-015-1255-z. Epub 2015 May 20.

How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients.

Author information

1
Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, 43126, Parma, Italy. erminia.ridolo@unipr.it.
2
Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, 43126, Parma, Italy.
3
Allergy Unit, G. da Saliceto Hospital, Piacenza, Italy.
4
Allergy Unit, Poma Hospital, Mantua, Italy.
5
Allergology Service, Department of Medicine and Public Health, University of Padua, Padua, Italy.
6
Allergy Outpatients Service, General Hospital, Treviglio, Italy.
7
Allergy and Immunology Unit, Department of Internal Medicine, Sant'OrsolaPoliambulanza Hospital, Brescia, Italy.
8
Allergy Unit, Verona University Hospital, Verona, Italy.
9
Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy.

Abstract

Self-administered adrenaline through an auto-injector is the main out-of-hospital treatment for anaphylaxis, and patients should be trained to promptly and correctly use the device. The aim of the study was to verify the proper use of the device and the correct drug administration, and to identify possible misuse by patients. In seven Italian Allergy clinics, patients who were previously provided with self-injectable adrenaline were recruited at the follow-up visit required for the renewal of their prescription. All patients completed a questionnaire covering details of their allergic reactions, and knowledge of the device. The correct use was verified by the physician using a trainer with a four-step examination. 242 patients were included; 46 patients (18 %) did not always carry the auto-injector, and 35 patients (14 %) reported situations in which they were doubtful about whether to use adrenaline. Only 39 % of patients properly managed the device, while some patients (6 %) failed in all four steps. The majority of patients considered it appropriate to use adrenaline at the onset of respiratory symptoms (56 %). The factor most closely related to proper use of the device was the education of the patient (p = 0.03), while age and the time from first prescription did not affect the ability to properly use the auto-injector. Even though accurate training is conducted, many patients are still unable to properly use the adrenaline auto-injector in case of anaphylaxis. Allergists should review the instructions provided to the patients every time a renewal of the auto-injector is prescribed.

KEYWORDS:

Adrenaline; Anaphylaxis; Auto-injector

PMID:
25990486
DOI:
10.1007/s11739-015-1255-z
[Indexed for MEDLINE]

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