An Intervention to Increase High School Students’ Compliance With Carrying Auto-Injectable Epinephrine

Abstract

Adolescents with life-threatening allergies are at a greater risk for a fatal anaphylactic event since only about half of them carry unexpired epinephrine available for emergency use. The aim of this study was to test the effectiveness of school nurse interventions that consisted of either routine or periodic checks during the school year for the availability of unexpired auto-injectable epinephrine. Seventy-seven students from 11 Massachusetts high schools participated in this study. Descriptive and chi-square (χ²) statistics as well as the Fisher's exact test were used to analyze data. Findings suggest that while periodic checks for the availability of epinephrine throughout the school year do not increase the likelihood that students will have epinephrine available, those students who do carry their epinephrine are more likely to have unexpired medication with periodic reminders during the school year.

Management of anaphylaxis: a systematic review

“…A quasi‐experimental trial evaluated whether an educational intervention could improve compliance with carrying an in‐date adrenaline auto‐injector in high school children with food allergy . The intervention failed to demonstrate any significant difference in carriage rates in the intervention and control groups.…”

A behavioral economics intervention to encourage epinephrine-carrying among food-allergic adults: a randomized controlled trial

“…Although the check-ins did not promote the carrying of epinephrine auto-injectors per se, more frequent check-ins were associated with maintenance of unexpired medication. 14 To encourage young adults diagnosed with food allergies to carry their epinephrine auto-injectors with them, the authors conducted a mixed-methods randomized controlled trial incorporating quantitative and qualitative assessments. Three strategies informed by behavioral economics were used.…”

Training and administration of epinephrine auto-injectors for anaphylaxis treatment in US schools: results from the EpiPen4Schools® pilot survey

“…Along with the need for adequate staff training, it is important for schools to stock epinephrine because of the risk of reactions in individuals without previously known life-threatening allergies 3 and because children and adolescents with known risk factors often fail to carry an unexpired EAI 15 or do not have ready access to an EAI. 16 Additionally, the majority of individuals at high risk of anaphylaxis do not receive personal prescriptions for EAIs.…”