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Anaphylaxis Preparedness Initiative for Allergen Immunotherapy Implementation of a Policy for Carrying Autoinjectable Epinephrine
Monday, March 7, 2016: 2:00 PM
Room 406AB (Convention Center)
Ahila Subramanian, MD, MPH, , , , , ,
Rationale: Subcutaneous immunotherapy (SCIT) is efficacious for allergic rhinitis and asthma. Due to the potential for severe and delayed systemic reactions (SR), we implemented a mandatory policy for all patients to carry autoinjectable epinephrine in association with receiving SCIT. 

Methods: A voluntary and anonymous survey was given to patients receiving SCIT. The survey included demographics and patient satisfaction questions, and used a 5-point Likert scale. 

Results: Over a 2-week period, 121 surveys were collected at three sites, accounting for 39% of inhalant immunotherapy patients; 61.9% were female, 38.1% were male, 45.3% were on build-up, 54.7% on maintenance. Median age was 39 years. Most patients (85%) agreed or strongly agreed that immunotherapy has been helpful, there was a difference in patients on build up (77.4%) compared to maintenance (92.2%), p=0.034. Most (72.4%) respondents agreed that the financial cost of an epinephrine autoinjector is worth the benefit of having it available in case of SR; there was a difference between patients on build-up (84.9%) vs. maintenance (61.9%), p=0.002. Only 19.6% of respondents agreed or strongly agreed that having epinephrine is not necessary for receiving SCIT, this differed in patients on build-up (13.2%) vs. maintenance (25%), p=0.19.

Conclusions: This study demonstrates the feasibility of implementing a universal policy for autoinjectable epinephrine in a large academic center.  The majority of our patients receiving SCIT agree and have complied with the recommendation for having an epinephrine autoinjector, while continuing to receive SCIT.