Epinephrine Is Underused During Serious Reactions

Nearly half of adults who are prescribed epinephrine did not use their epinephrine auto-injectors (EAI) during a potentially life-threatening allergic reaction, according to a recent study.

Previous research has suggested that emergency use and daily carriage of EAIs is inadequate.


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In order to further explore rates of EAI carriage and barriers to use, the researchers conducted a study including data from 597 surveys representing 917 individuals, with some participants providing information for themselves and for children with an EAI prescription. The study included data from 255 children aged 0-12 years, 212 adolescents aged 13-17 years, and 450 adults aged 18-65 years.

Although 89% of the surveyed individuals reported filling prescriptions for an EAI and 78% reporting that they had been hospitalized for their allergy at some point in the past, 45% said that when they experienced a severe allergic reaction, they did not have the EAI with them. Further, 21% reported being unsure of how to use their EAI.

The most commonly cited barriers to filling an EAI prescription among adults included cost (47%), perception that allergy was not severe (23%), and no history of allergic reactions (20%), while no history of allergic reactions (28%) and perception that allergy was not severe (25%) were the most common among children.

“[T]hese data suggest that current EAI carriage practices among allergic patients are suboptimal and may be improved through reducing EAI-related out-of-pocket costs and facilitating patient education efforts aimed at increasing knowledge and self-efficacy regarding how/when to effectively use EAIs,” the researchers concluded.

—Michael Potts


Warren CW, Zaslavsky JM, Kan K, et al. Auto-injector carriage and use practices among US children, adolescents, and adults [published online June 21, 2018]. Annals of Allergy, Asthma Immunology. doi: 10.1016/j.anai.2018.06.010.