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Epinephrine autoinjector refill history in an HMO
Michael S Kaplan1, Sandy Y Jung, Matthew L Chiang
1Department of Allergy and Clinical Immunology, Kaiser Permanente, Los Angeles Medical Center, 1515 North Vermont, Los Angeles, CA 90046, USA. michael.s.kaplan@kp.org
Current Allergy and Asthma Reports
|October 20, 2010
Summary
Many patients diagnosed with anaphylaxis do not refill their epinephrine prescriptions. This study tracked 14,677 patients, finding only 46% refilled their epinephrine, highlighting a gap in anaphylaxis preparedness.
Area of Science:
- Allergy and Immunology
- Public Health
- Pharmacology
Background:
- Epinephrine is critical for managing anaphylaxis, a severe allergic reaction.
- Underprescription and underuse of epinephrine auto-injectors remain significant concerns.
- Tracking epinephrine refill patterns is essential for assessing patient adherence and access.
Purpose of the Study:
- To analyze epinephrine refill patterns in a large cohort of patients diagnosed with anaphylaxis.
- To identify factors associated with epinephrine refill adherence.
- To understand the utilization of epinephrine auto-injectors over time.
Main Methods:
- Retrospective analysis of 14,677 patients receiving initial epinephrine dispensing (EpiPen/EpiPen Jr) between 2000-2006.
- Inclusion of patients with a diagnosis of anaphylaxis from a large health maintenance organization (HMO).
- Examination of refill history, demographic data, and linked ICD-9 diagnostic codes.
Main Results:
- Only 46% (6,776) of patients refilled their epinephrine at least once.
- Younger patients (infants to 12 years) were more likely to refill (63%) than adolescents and adults (40%).
- Patients with food allergy (79%) and insect sting allergies (59%) showed higher refill rates.
Conclusions:
- A substantial proportion of patients at risk for anaphylaxis do not consistently refill their epinephrine prescriptions.
- Age and specific allergy type (food, insect sting) influence refill behavior.
- Addressing system and personal barriers is crucial to improve epinephrine access and adherence for anaphylaxis management.
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