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Correct Use of Epinephrine Autoinjectors in Relation to Health Literacy in Patients with Food Allergies
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Maureen Egan, MD, Julie Wang, MD FAAAAI
Rationale: Anaphylaxis occurs in an estimated 1.6% of the United States population with food allergies being the trigger in 31% of cases. Epinephrine Autoinjectors (EA) are essential in management of anaphylaxis.   A national assessment of health literacy noted that 44% of adults have below or basic health literacy, which is associated with adverse health outcomes. However, no study to date has examined the correct use of EA in relation to health literacy.  

Methods: Parents of children with known food allergies who had previously been prescribed an EpiPen were included.  Participants were administered the Newest Vital Sign (NVS), a validated instrument to assess health literacy. Additionally, subjects demonstrated use of an EpiPen that was evaluated based on a previously established 6 step checklist. 

Results: 38 subjects were approached, 2 declined to participate.  Of the 36 parents included, 8.3% had a score of 0-1 on NVS assessment indicating a high likelihood of limited literacy, 16.7% had a score of 2-3 indicating possible limited literacy while 75% patients had a score of 4-6 indicating likely adequate health literacy. Amongst patients with a NVS score of <4, 44% (4/9) demonstrated correct use of an EpiPen (correct use defined as proper demonstration of all 6 steps).  Among patients with a NVS of ≥4, 48% (13/27) demonstrated correct use. The difference between the groups was not statistically significant (p=0.85).

Conclusions: Correct use of EpiPen was demonstrated in less than 50% of parents of children with known food allergies. The ability to correctly demonstrate use of EpiPen was not correlated with health literacy adequacy.