Supervised Empty-Syringe Self-Injection Improves Adolescents’ Comfort with Epinephrine Self-Injection

Published online: January 20, 2017

People with severe allergies must carry and inject epinephrine promptly in the event of anaphylaxis, a life-threatening allergic reaction. Epinephrine can be self-administered from an autoinjector.  Anxiety and discomfort related to the need to self-inject epinephrine contributes to food-allergic adolescents’ occasional failure to carry or use an autoinjector, a problem associated with fatalities. Drs. Eyal Shemesh and Scott Sicherer and their colleagues from the EMPOWER program at the Jaffe Food Allergy Institute in the Department of Pediatrics at the Icahn School of Medicine at Mount Sinai in New York

In a study published in The Journal of Allergy and Clinical Immunology: In Practice, Shemesh and colleagues conducted a trial of an intervention aimed at improving teens’ comfort with self-injection. The study included 60 adolescents who agreed to participate.  The teens were randomized to supervised and guided self-injection using a needle mounted on an empty syringe (no air or medication) compared to receiving education about self-injection without having to practice with a real needle (the control group). The study evaluated differences in comfort level with self-injection between the groups before vs. after the intervention on a questionnaire with scores of 1 (not at all comfortable) to 10 (extremely comfortable).  

The group undergoing self-injection experienced a significant immediate increase in comfort levels with self-injection and with other pre-defined measures such as having decreased worry and increased willingness to self-inject.  

The authors concluded that for adolescents with food allergy who need to carry and use an autoinjector, a supervised self-injection procedure improved comfort with self-injection, and decreased anxiety related to the anticipated need to self-inject. This simple procedure can be incorporated into standard practice wherever food allergy is managed.  It may substantially increase the number of adolescents that are able to take care of themselves during an emergency if the need arises.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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