Assessment of the use of adrenaline auto-injectors among adult patients at risk of anaphylaxis

Introduction
Carriage and correct use of adrenaline auto-injectors (AAIs) by patients have been reported to be low. Aim: To evaluate the carriage rate of the EpiPen® and the usage skills of the adult patients.

Material and methods
A total of 46 patients who had been previously prescribed EpiPen® were enrolled during a five-month period in our clinic. Data about the EpiPen® prescription indications and prescription date, the number of the device usage training sessions, the last training date, and the reasons for not carrying the device were obtained. Patients were practically evaluated with a trainer device.

Results
Among 46 patients, 20 (43%) were female, and the mean age of the patients was 45 ±13 years (min.–max.: 20–67). EpiPen® prescription indication included Hymenoptera venom allergy in 44 patients, food allergy in one patient, and idiopathic anaphylaxis in one patient. Twenty-nine (63%) patients reported that they kept the device with them always, whereas 17 (37%) reported they did not. The most frequently stated reason for not carrying an EpiPen® was the thought that it was unnecessary (n = 6, 35%). Of 29 patients, 11 (38%) correctly demonstrated all the steps of the trainer device. The most frequent mistake was failing to remove the cap (n = 15, 83%)

Conclusions
The significance of always carrying the device at all times should be emphasized, as should the importance of correct use of the device in patients’ routine controls. Trainings given at least twice a year may be supported by reminders via telephone call or e-mail.