Inconsistences in prescribing epinephrine autoinjectors
File(s)
Published version (pre-proof)
Author(s)
Type
Journal Article
Abstract
A key strategy in supporting patients at risk of anaphylaxis is the provision of self-administered epinephrine (“self-epi”). However, there seems to be a lower threshold for prescribing self-epi in food allergy than for venom. Self-epi is often recommended to someone where the risk of food-anaphylaxis is relatively low (under 5%) yet a similar level of risk in a venom-allergic patient is considered not to justify self-epi. We can only speculate as to the reasons for this: it may be harder to avoid food allergens (which can be hidden and undisclosed) compared to a bee or wasp, and the effort needed to avoid food allergens is greater. Evidence suggests that self-epi does not reduce rates of hospitalization or fatal anaphylaxis. Therefore, the rationale for self-epi should be based on supporting patients and empowering them to lead a more normal life. Surprisingly, studies suggest that self-epi has an adverse impact on quality-of-life, perhaps because it creates a perception that those with self-epi are more at risk of a life-threatening reaction. We must be cognizant of the fact that when the risk of anaphylaxis is relatively low, the prescription of self-epi can be associated with harms as well as potential benefits.
Date Issued
2025-08-05
Date Acceptance
2025-07-23
Citation
Journal of Allergy and Clinical Immunology: In Practice, 2025
ISSN
2213-2198
Publisher
Elsevier
Journal / Book Title
Journal of Allergy and Clinical Immunology: In Practice
Copyright Statement
© 2025 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology
License URL
Publication Status
Published online
Date Publish Online
2025-08-05