A randomized maternal evaluation of epinephrine autoinjection devices

Area of Science:

• Anaphylaxis management
• Medical device usability
• Patient training and education

Background:

• Intramuscular epinephrine (adrenaline) is the primary treatment for anaphylaxis, with prompt administration crucial for positive outcomes.
• In the UK, EpiPen® and Anapen® were the available epinephrine autoinjectors in 2011, featuring distinct user administration methods.
• Standardized training is routinely provided to families receiving these devices.

Purpose of the Study:

• To assess maternal competence in using epinephrine autoinjectors after a standard training program.
• To determine which epinephrine autoinjector device, EpiPen® or Anapen®, mothers found easier to operate.

Main Methods:

• One hundred mothers with no prior experience were recruited.
• A single clinician provided a standardized demonstration of a randomly assigned autoinjector.
• Mothers' immediate performance was evaluated against ten criteria (four device-specific, six common).

Main Results:

• 15% of mothers could not successfully operate the training devices, with higher failure rates for EpiPen® (26%) compared to Anapen® (4%).
• Only 22% of mothers successfully completed all ten procedures; Anapen® users (32%) performed significantly better than EpiPen® users (12%).
• Mothers demonstrated significantly higher correct performance of Anapen®-specific procedures compared to EpiPen®-specific procedures.

Conclusions:

• A significant percentage of mothers (15%) were unable to correctly operate epinephrine autoinjectors post-demonstration, indicating a need for more user-friendly devices and enhanced training.
• The Anapen® device was perceived as significantly easier to use by mothers, suggesting potential implications for future prescription choices.
• Further evaluation of next-generation autoinjectors and their associated training packages is recommended due to observed practical differences in usability.