Only half of adults with a food allergy have ever been prescribed an epinephrine auto-injector, a survey finds. Only one in three currently have an unexpired epinephrine auto-injector for use in case of an allergic reaction.
When asked why they didn’t have an auto-injector, many blamed their doctors, claiming their physician “did not indicate it was really needed.” The second most common reason stated for not having an auto-injector was not understanding that they might need one.
“We were shocked to find this. We went in thinking that insurance coverage and cost would be the biggest reasons people can’t access [auto-injectors], but the biggest reason seems to be their doctor didn’t indicate it was needed,” says Jennaveve Yost, the lead study author.
“There is a lot of room for more patient education around the potential seriousness of food allergies, and that if you have a food allergy, you should have a prescription for an epinephrine auto-injector, said Yost, the health education research manager for the nonprofit FARE.
The survey was conducted by the Food Allergy Collaborative, a group of food allergy advocacy organizations. It included a nationally representative sample of more than 1,000 food-allergic adults. All participants reported having experienced a serious allergic reaction involving two or more body systems after consuming one of the top nine food allergens.
Epinephrine is the medication prescribed to halt an anaphylactic reaction. Yet many feared side effects, with 36 percent believing they can be “life-threatening.”
Lack of Epi ‘Worrisome’
Erin Malawer, senior study author and executive director of the nonprofit AllergyStrong, called the findings “worrisome.” “People with food and other severe allergies that can cause anaphylaxis need to understand that epinephrine is the first line of defense,” she says.
Epinephrine is known to be very safe, with side effects such as a racing heartbeat, nausea, sweating, dizziness or shakiness. These effects typically wear off in about a half hour. The hesitancy regarding epinephrine echoes previous research, which finds the drug underused in serious allergic reactions by parents, caregivers and even hospital staff.
In the current survey, 61 percent of respondents were Caucasian, 16 percent were Black, 15 percent were Hispanic and 7 percent were Asian, Native American, or another ethnicity.
About 77 percent said they had seen a doctor in the previous year, with 42 percent saying they saw a primary care provider while 27 percent saw an allergist. About 23 percent had not seen a healthcare provider in the past year.
Those with private health insurance were more likely to have been prescribed an auto-injector than those with Medicare or Medicaid.
Even those who said they had been prescribed an epinephrine auto-injector at some point didn’t necessarily have one close at hand, in case of emergency. Among respondents who had been prescribed an auto-injector, 45 percent said they couldn’t necessarily access it within five minutes, while 55 percent said they had access to it all the time.
“We would love that number to be 100 percent,” Yost says.
The survey findings were presented at the 2022 American College of Allergy, Asthma and Immunology (ACAAI) Annual Scientific Meeting in Kentucky.
Related Reading:
All About Epinephrine: What It Does, When It Gets Hot or Cold
50% of Adults Not Getting Epinephrine in Anaphylaxis
Why Some Ambulances in the U.S. Don’t Stock Epinephrine