Pouessel G, Deschildre A, Castelain C, et al. Pediatr Allergy Immunol. 2006:17:221–226
PURPOSE OF THE STUDY. To assess parental use and knowledge of an epinephrine autoinjector (EAI), Anapen, prescribed for their food-allergic child(ren), and to examine the availability of emergency kits and personalized care plans.
STUDY POPULATION. The parents of 152 food-allergic children prescribed an EAI between June 2000 and March 2003 at 1 of 5 children's hospitals in northern France.
METHODS. An anonymous-questionnaire format was used to collect details on the child's clinical manifestations of allergies, EAI education by a health care provider, verification of proper EAI use at each follow-up visit, availability of a personalized care plan at school, physician instructions in case of allergic reaction, and medications available at home or outside the home. Parents were also asked to list symptoms that required epinephrine (open-ended item).
RESULTS. One hundred nine families representing 111 children completed and returned the survey. The majority (90%) of families had the use of Anapen demonstrated (76% with a trainer device), and 83% had received written instructions. Nineteen percent had a repeat demonstration at follow-up visits, and 10% never received a demonstration; yet, 88% of parents felt that they could use an EAI in an emergency. Only 54% of school-aged children had a personalized care plan, and 11% had an EAI at school with no personalized care plan. Only 48% of the parents could list >1 symptom that required an EAI. There was no difference in the quality of instructions between pediatricians and allergists and no difference in knowledge between parental socioeconomic groups.
CONCLUSIONS. EAIs and personal care plans were insufficiently available at schools and in daily life. Proper EAI use and education were unsatisfactory.
REVIEWER COMMENTS. This study emphasized the importance of extensive and repeated education about food-allergy risks and measures that need to be in place in case of an emergency. Although a majority of parents felt that they knew how to use an EAI, many could not recognize >1 symptom that would require the use of an EAI, and nearly half of the patients did not have an EAI or emergency plan available at school. A disturbing number (10%) of parents never received EAI education, and for those who received education, only a few (19%) had a review of instructions at follow-up. Repeated EAI education is important, because skills acquired at the initial visit are likely to be lost if they are not practiced, and failure to reiterate the importance of knowing how or when to use an EAI may contribute to parents’ indifferent attitude about carrying an EAI or submitting an appropriate personal care plan to the child's school.
- Copyright © 2007 by the American Academy of Pediatrics