Practices in the prescription of adrenaline autoinjectors

Abstract

Background: Anecdotally, the prescription of adrenaline autoinjectors seems to be very variable. We aimed to survey the practice in this area and look at the differences between paediatric allergists and general paediatricians, the factors influencing prescription and implementation of current guidelines.

Methods: We developed an online survey containing 10 paediatric allergy cases and emailed a link to paediatricians. Respondents were asked to identify their prescribing decision in each case, the factors influencing their decisions and which guidelines they had read.

Results: Responses were collated from 54 paediatric allergists and 27 general paediatricians. Almost all respondents had read at least one guideline. Prescribing decisions were very inconsistent, and significant influencing factors included peanut or tree nut allergy, trace reactions, remote facilities and parental anxiety.

Conclusions: This study demonstrates that most paediatricians have read at least one anaphylaxis guideline. However, reading the guidelines does not seem to have influenced their daily practice. This suggests that there is a need for improved implementation of anaphylaxis guidelines amongst paediatricians.