Anaphylaxis in the community: learning from the survivors

Area of Science:

• Allergy and Immunology
• Emergency Medicine
• Public Health

Background:

• Community anaphylaxis research often focuses on at-risk populations rather than actual survivors.
• This study shifts focus to the experiences of individuals who have survived anaphylaxis.

Purpose of the Study:

• To investigate the experiences of community anaphylaxis survivors regarding epinephrine autoinjector use.
• To understand the reasons behind both the use and non-use of epinephrine autoinjectors in real-world anaphylaxis events.

Main Methods:

• An anonymous email survey was administered to 1885 self-reported anaphylaxis survivors.
• The survey included core questions for all participants and specific modules for epinephrine users and nonusers.
• Anaphylaxis was defined as the most severe sudden-onset allergic reaction experienced by the participant or their dependent.

Main Results:

• Out of 1885 participants, 27% were epinephrine users and 73% were nonusers.
• Epinephrine users were more likely to report respiratory/shock symptoms, specific triggers (peanut, fish, insect), asthma, and recent asthma medication use.
• Nonusers cited reasons for not using epinephrine, including H1-antihistamine use (38%), lack of prescription (28%), and perceived mildness of the reaction (13%).

Conclusions:

• In this community-based cohort of anaphylaxis survivors, nonusers of epinephrine autoinjectors significantly outnumbered users.
• Epinephrine users reported challenges in treatment decisions, including dose repetition and seeking emergency care.
• Understanding nonusers' reasons is crucial for improving anaphylaxis first-aid practices and autoinjector accessibility.