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How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients

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Abstract

Self-administered adrenaline through an auto-injector is the main out-of-hospital treatment for anaphylaxis, and patients should be trained to promptly and correctly use the device. The aim of the study was to verify the proper use of the device and the correct drug administration, and to identify possible misuse by patients. In seven Italian Allergy clinics, patients who were previously provided with self-injectable adrenaline were recruited at the follow-up visit required for the renewal of their prescription. All patients completed a questionnaire covering details of their allergic reactions, and knowledge of the device. The correct use was verified by the physician using a trainer with a four-step examination. 242 patients were included; 46 patients (18 %) did not always carry the auto-injector, and 35 patients (14 %) reported situations in which they were doubtful about whether to use adrenaline. Only 39 % of patients properly managed the device, while some patients (6 %) failed in all four steps. The majority of patients considered it appropriate to use adrenaline at the onset of respiratory symptoms (56 %). The factor most closely related to proper use of the device was the education of the patient (p = 0.03), while age and the time from first prescription did not affect the ability to properly use the auto-injector. Even though accurate training is conducted, many patients are still unable to properly use the adrenaline auto-injector in case of anaphylaxis. Allergists should review the instructions provided to the patients every time a renewal of the auto-injector is prescribed.

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Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

The study was approved by the Ethical Committee of Guglielmo da Saliceto Hospital, Piacenza, Italy.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Authors and Affiliations

  1. Department of Clinical and Experimental Medicine, University of Parma, via Gramsci 14, 43126, Parma, Italy

    Erminia Ridolo, Marcello Montagni & Laura Bonzano

  2. Allergy Unit, G. da Saliceto Hospital, Piacenza, Italy

    Eleonora Savi & Silvia Peveri

  3. Allergy Unit, Poma Hospital, Mantua, Italy

    Maria Teresa Costantino

  4. Allergology Service, Department of Medicine and Public Health, University of Padua, Padua, Italy

    Mariangiola Crivellaro

  5. Allergy Outpatients Service, General Hospital, Treviglio, Italy

    Giuseppina Manzotti

  6. Allergy and Immunology Unit, Department of Internal Medicine, Sant’OrsolaPoliambulanza Hospital, Brescia, Italy

    Carlo Lombardi

  7. Allergy Unit, Verona University Hospital, Verona, Italy

    Marco Caminati & Gianenrico Senna

  8. Allergy/Pulmonary Rehabilitation, ICP Hospital, Milan, Italy

    Cristoforo Incorvaia

Authors
  1. Erminia Ridolo
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  2. Marcello Montagni
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  3. Laura Bonzano
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  4. Eleonora Savi
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  5. Silvia Peveri
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  6. Maria Teresa Costantino
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  7. Mariangiola Crivellaro
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  8. Giuseppina Manzotti
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  9. Carlo Lombardi
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  10. Marco Caminati
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  11. Cristoforo Incorvaia
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  12. Gianenrico Senna
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Corresponding author

Correspondence to Erminia Ridolo.

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Ridolo, E., Montagni, M., Bonzano, L. et al. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med 10, 937–941 (2015). https://doi.org/10.1007/s11739-015-1255-z

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  • DOI: https://doi.org/10.1007/s11739-015-1255-z

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