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. 2017 Apr;67(657):e300-e305.
doi: 10.3399/bjgp17X689917. Epub 2017 Mar 13.

Prescription rates of adrenaline auto-injectors for children in UK general practice: a retrospective cohort study

Lavanya Diwakar  1 , Carole Cummins  2 , Ronan Ryan  3 , Tom Marshall  2 , Tracy Roberts  2
Affiliations

Prescription rates of adrenaline auto-injectors for children in UK general practice: a retrospective cohort study

Lavanya Diwakar et al. Br J Gen Pract. 2017 Apr.

Abstract

Background: Adrenaline auto-injectors (AAI) should be provided to individuals considered to be at high risk of anaphylaxis. There is some evidence that the rate of AAI prescription is increasing, but the true extent has not been previously quantified.

Aim: To estimate the trends in annual GP-issued prescriptions for AAI among UK children between 2000 and 2012.

Design and setting: Retrospective cohort study using data from primary care practices that contributed to The Health Improvement Network (THIN) database.

Method: Children and young people aged between 0-17 years of age with a prescription for AAIs were identified, and annual AAI device prescription rates were estimated using Stata (version 12).

Results: A total of 1.06 million UK children were identified, providing 5.1 million person years of follow-up data. Overall, 23 837 children were deemed high risk by their GPs, and were prescribed 98 737 AAI devices. This equates to 4.67 children (95% confidence interval [CI] = 4.66 to 4.69), and 19.4 (95% CI = 19.2 to 19.5) devices per 1000 person years. Between 2000 and 2012, there has been a 355% increase in the number of children prescribed devices, and a 506% increase in the total number of AAI devices prescribed per 1000 person years in the UK. The number of devices issued per high-risk child during this period has also increased by 33%.

Conclusion: The number of children being prescribed AAI devices and the number of devices being prescribed in UK primary care between 2000 and 2012 has significantly increased. A discussion to promote rational prescribing of AAIs in the NHS is needed.

Keywords: adrenaline; allergy; anaphylaxis; database; general practice; prescriptions; primary health care.

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Figures

Figure 1.
Figure 1.
Trends in proportion of children with AAI devices and the overall rate of AAI device availability in the UK by year.
Figure 2.
Figure 2.
Proportion of children receiving one to four or more adrenaline auto-injectors (AAI) devices in the years 2000 to 2012.
See this image and copyright information in PMC

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