SELECTED ARTICLES FROM THE RECENT LITERATURE 2005

10/11/05

Use of Epi-Pen in children with food allergies

Summary
Background - Epi-Pen is often under used in children who have had anaphylactic (Ana) reactions to foods. It is very possible that such under use may reflect parental discomfort with administering Epi-Pen.

Findings - Kim et al of Northwestern Univ in Chicago sent a written survey to parents of children for whom Epi-Pen had been prescribed because of the potential for Ana reactions to foods. A visual analogue scale was used to determine the perceived level of parental comfort with administering Epi-pen. The knowledge about Ana and Epi-Pen use was tested with multiple-choice questions.

Of the 165 children whose parents completed the questionnaire, Ana episodes had previously occurred in 70 children (42%) for whom Epi-Pen had been prescribed. The parents of only 14 of these 70 children had administered Epi-Pen. Such use of Epi-Pen tended to be carried out by parents who had used the Epi-pen for earlier Ana episodes and by those parents who felt "empowered" to use this treatment. Knowledge about Ana and about the technique for using Epi-Pen was not associated with its use.

Reference
J Allergy Clin Immunol 2005;116:164-8

Editor's Comments
This questionnaire study had some limitations (patient population somewhat selected; only 46% of questionnaires completed/submitted). Nevertheless, some important information was obtained that should help physicians to increase the likelihood that prescribed Epi-Pen units would be used when indicated. Knowledge about Ana manifestations and when/how to use an Epi-Pen is apparently not sufficient to assure appropriate use of automated epinephrine injectors. The parent must feel "empowered" (have the right) to use this device. Once an Epi-Pen has been used by a parent in the past, that individual apparently has much less concern about using it again.

 

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