Food-induced anaphylaxis: low patient concordance with post-discharge care guidelines
Published Online: September 9, 2013
Food-induced anaphylaxis is a potentially life-threatening systemic allergic reaction that often results in emergency department (ED) visits and/or hospitalization. Epinephrine is the first-line treatment for anaphylaxis and its prompt and correct administration can be lifesaving. After an ED visit/hospitalization for anaphylaxis, US national guidelines recommend several actions, including prescription of an epinephrine auto-injector (EAI) and referral to an allergist/immunologist.
In a recent study of healthcare claims in 1,370 US adults, published in The Journal of Allergy and Clinical Immunology: In Practice, Landsman-Blumberg et al examined patient concordance with recommended post-discharge care after an ED visit or hospitalization for food-induced anaphylaxis. While previous studies investigated physician adherence with US national guidelines, the new study evaluated if patients actually fill/refill an EAI prescription and visit a specialist post-discharge. The investigators also examined the frequency of repeat anaphylaxis events over 1 year of follow-up.
The investigators found low patient concordance with recommended post-discharge care, particularly for visiting an allergist/immunologist. Within 1 year after discharge from the ED or hospital, 54% of patients had filled an EAI prescription, while only 22% had visited an allergist/immunologist. Overall, 5% of patients had evidence of another anaphylaxis-related ED visit/hospitalization during the follow-up year.
In summary, concordance with recommended post-discharge anaphylaxis care was low among adults with food-induced anaphylaxis. Results of this study suggest the need for increased physician and patient education to improve patient concordance with recommended post-discharge anaphylaxis care, and investigation of patient barriers to seeking such care, especially the recommendation to visit an allergist/immunologist.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.