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Likelihood of Having Self-Injectable Epinephrine in Adult and Pediatric Patients Presenting for Evaluation of Food Allergy
Saturday, March 5, 2016
South Exhibit Hall H (Convention Center)
Carolyn H. Baloh, MD, Daniel Winger, MS, Tara Shankar, MD, Merritt L. Fajt, MD, Todd David Green, MD FAAAAI
Rationale: Food allergy is a leading cause of anaphylaxis, and underprescription of epinephrine is well documented; we were interested in comparing trends related to this in pediatric and adult populations at one academic medical center.

Methods: Retrospective chart review of 100 pediatric and 222 adult patients seen at Children’s Hospital of Pittsburgh of UPMC or UPMC for a diagnosis of food allergy June 15, 2004 through June 15, 2014. 53 adult and 26 pediatric patients were excluded. Final adult n: 169. Final pediatric n: 74. This review was IRB exempt approved.

Results: 64% of adults and 58% of children seen by a physician for food allergy had self-injectable epinephrine prior to their first allergy visit. Adults referred by a PCP were significantly less likely to have epinephrine (p=0.036) than those seen by another physician, with a similar trend in children (p=0.070). 62% of adults and 86% of children previously treated with epinephrine for anaphylaxis had self-injectable epinephrine. Children (p=0.002) and adults (p=0.034) with tree nut allergy were more likely to have epinephrine than those with a different food allergy, including peanut. Peanut-allergic adults were more likely to have epinephrine (p=0.007). Milk-allergic children were less likely to have epinephrine (p=0.03), as were adults with fruit allergy (p=0.008). 42% of children avoiding 3 or more foods had epinephrine while 66% avoiding less than 3 foods had epinephrine (p=0.047), a trend not seen with adults.

Conclusions: Adult and pediatric patients presenting to an allergist for food allergy have a lower than optimal rate of having self-injectable epinephrine.