The compliance and burden of treatment with the epinephrine auto-injector in food-allergic adolescents

Pediatr Allergy Immunol. 2016 Feb;27(1):28-34. doi: 10.1111/pai.12458. Epub 2015 Oct 9.

Abstract

Background: Food-allergic patients at high risk of potential fatal anaphylaxis should carry an epinephrine auto-injector (EAI) at all times. This treatment may be perceived as burdensome and this may affect compliance and health-related quality of life (HRQL). The aims of the study were (1) to determine the burden of treatment (BoT) of an EAI, (2) to examine the relationship between this burden and compliance, and (3) to analyze which factors contribute to the BoT of the EAI as perceived by food-allergic adolescents and their parents.

Methods: Dutch food-allergic adolescents prescribed an EAI, and their parents completed a questionnaire package (n = 55). Relationships between BoT and HRQL, illness severity and perception, and anxiety measures were investigated.

Results: Food-allergic adolescents and their parents were (extremely) positive about the EAI (54.5%; 72.7%, respectively) (=low BoT). The BoT measure showed a significantly greater burden in food-allergic adolescents prescribed an EAI who reported not carrying the EAI at all times than adolescents who reported they did. The BoT scores of both adolescents and their parents were not associated with HRQL, illness severity and perception, or trait anxiety.

Conclusions: The majority of food-allergic adolescents and their parents were positive about the EAI (=low BoT). However, the BoT was significantly associated with self-reported compliance with carrying the EAI. The BoT was higher in food-allergic adolescents prescribed an EAI who reported not carrying the EAI at all times. The BoT measure seems to be a useful tool to study compliance with carrying an EAI. The BoT of an EAI is not associated with HRQL. The BoT measures a distinct concept related to compliance behavior.

Keywords: adolescents; burden of treatment; compliance; epinephrine auto-injector; food allergy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adolescent Behavior*
  • Age Factors
  • Anti-Allergic Agents / administration & dosage*
  • Anxiety / psychology
  • Cost of Illness*
  • Epinephrine / administration & dosage*
  • Female
  • Food Hypersensitivity / diagnosis
  • Food Hypersensitivity / drug therapy*
  • Food Hypersensitivity / psychology
  • Health Knowledge, Attitudes, Practice*
  • Humans
  • Injections
  • Male
  • Medication Adherence*
  • Middle Aged
  • Netherlands
  • Parents / psychology
  • Perception
  • Quality of Life
  • Self Administration*
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Outcome

Substances

  • Anti-Allergic Agents
  • Epinephrine