G148 Adrenaline autoinjectors: are we doing it right?. (May 2019)

• Record Type: Journal Article
• Authors: Chan, S; Bilal, S
• Is Part Of: Archives of disease in childhood. Volume 104:(2019)Supplement 2
• Page Start: A60
• Page End: A61
• Publication Date: 2019-05
• Subjects: Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/archdischild-2019-rcpch.144
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : The treatment of anaphylaxis is intramuscular adrenaline. The risk of recurrence depends on the quality of the management provided. The Medicines and Healthcare Regulatory Agency (MHRA) 2017 safety update recommends that 2 Adrenaline Autoinjectors (AAI) should be prescribed. The 2016 BSACI guideline recommends that AAI training should be refreshed at each appointment but it does not mention the recommended duration between each AAI training. Aims: Our retrospective cohort study evaluated if patients are being prescribed the correct number of AAI according to the MHRA safety update and if AAIs are prescribed appropriately as per the BSACI AAI Prescribing Guidelines. We also evaluated the confidence of patients or their parents on the use of their AAI and associated their confidence levels with the duration of last AAI training. Methods: 24 patients with an AAI prescribed, or their parents for younger children, who attended the Allergy outpatient clinic at a district hospital between January and April 2018 were asked for written consent to participate in this retrospective cohort observational study. We assessed their confidence level on using the AAI in anaphylaxis based on a score of 1 to 10, with 10 being the most confident. Results: 100% of patient had 2 AAIs prescribed. 100% had training on use of AAI. However, 33% of patients have not used a training AAI. Only 16.7% of patients have used a training AAI video. 66% had their last training more than 1 year ago and this ranged between 14 months to 3 years. The average confidence score of patients who had training more than 1 year ago was 6 compared to 8 in patients who had training within 1 year. 100% of patients were prescribed an AAI accurately according to the BSACI Prescribing Guideline. Conclusion: A guideline will be developed on the interval of AAI training and recommend that AAI training is offered annually. Training AAI and videos should be given as part of AAI training. We also proposed an Allergy Clinic Proforma checklist to remind us about duration of last training, action plans, and provision of a training AAIs and training videos.