Effects of a structured educational intervention on knowledge and emergency management in patients at risk for anaphylaxis

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Nasal allergen challenge (NAC) is an important tool to diagnose allergic rhinitis. In daily clinical routine, experimentally, or when measuring therapeutic success clinically, nasal allergen challenge is fundamental. It is further one of the key diagnostic tools when initiating specific allergen immunotherapy. So far, national recommendations offered guidance on its execution; however, international divergence left many questions unanswered. These differences in the literature caused EAACI to initiate a task force to answer unmet needs and find a consensus in executing nasal allergen challenge. On the basis of a systematic review containing nasal allergen challenges of the past years, task force members reviewed evidence, discussed open issues, and studied variations of several subjective and objective assessment parameters to propose a standardized way of a nasal allergen challenge procedure in clinical practice. Besides an update on indications, contraindications, and preparations for the test procedure, main recommendations are a bilaterally challenge with standardized allergens, with a spray device offering 0.1 mL per nostril. A systematic catalogue for positivity criteria is given for the variety of established subjective and objective assessment methods as well as a schedule for the challenge procedure. The task force recommends a unified protocol for NAC for daily clinical practice, aiming at eliminating the previous difficulty of comparing NAC results due to unmet needs.

Section: Resultsmentioning

confidence: 99%

EAACI Position paper on the standardization of nasal allergen challenges

Augé

Vent

Agache

et al. 2018

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262

“…Therefore, it is necessary to increase awareness in the medical community and to educate physicians in prevention of anaphylaxis and the use of SIA. Moreover, structured patient education programs are beneficial in the management of anaphylaxis by increasing patients’ knowledge of the correct use of the auto‐injector in an episode of anaphylaxis .…”

Section: Discussionmentioning

confidence: 99%

Adrenaline in anaphylaxis treatment and self-administration: experience from an inner city emergency department

Mostmans

Grosber

Blykers

et al. 2016

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The majority of patients were treated according to the EAACI guidelines for management of anaphylaxis, but only a minority received the recommended adrenaline auto-injector for self-administration at discharge. Because the majority of patients received medical help later than 30 min after symptom onset, adrenaline auto-injector prescription is a necessity. The low rate of doctors prescribing adrenaline auto-injectors in the ED setting underlines the need to train doctors of various backgrounds in prevention and treatment of anaphylaxis and the close collaboration with allergologists.

“…[4][5][6] Providing detailed information regarding the cause, nature, and countermeasures decreases insecurity and increases the patients' quality of life. 7 Therefore, different international guidelines emphasize the importance of secondary prevention measures. 8,9 In this study, we analyzed the data acquired from the Anaphylaxis Registry regarding the range of secondary prevention measures offered to patients in specialized allergy centers and by primary care providers.…”

Section: Introductionmentioning

confidence: 99%

Secondary prevention measures in anaphylaxis patients: Data from the anaphylaxis registry

Kraft

Knop

Renaudin

et al. 2019

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. AbstractBackground: Patients with a history of anaphylaxis are at risk of future anaphylactic reactions. Thus, secondary prevention measures are recommended for these patients to prevent or attenuate the next reaction.Methods: Data from the Anaphylaxis Registry were analyzed to identify secondary prevention measures offered to patients who experienced anaphylaxis. Our analysis included 7788 cases from 10 European countries and Brazil. Results:The secondary prevention measures offered varied across the elicitors. A remarkable discrepancy was observed between prevention measures offered in specialized allergy centers (84% of patients were prescribed adrenaline autoinjectors following EAACI guidelines) and outside the centers: Here, EAACI guideline adherence was only 37%. In the multivariate analysis, the elicitor of the reaction, age of the patient, mastocytosis as comorbidity, severity of the reaction, and reimbursement/ availability of the autoinjector influence physician's decision to prescribe one.Conclusions: Based on the low implementation of guidelines concerning secondary prevention measures outside of specialized allergy centers, our findings highlight the importance of these specialized centers and the requirement of better education for primary healthcare and emergency physicians. K E Y W O R D Sadrenaline autoinjector, anaphylactic reaction, anaphylaxis, epinephrine autoinjector, secondary prevention