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Patient perceptions of epinephrine auto-injectors: exploring barriers to use

Patient perceptions of epinephrine auto-injectors: exploring barriers to use
Patient perceptions of epinephrine auto-injectors: exploring barriers to use
Background:? In recent years, government initiatives have proposed that patient self-care should serve as a key resource in response to the anticipated increase in global demand for health care. However, if patients are to be empowered as self-carers, barriers to engagement must be identified and overcome. Anaphylaxis is an increasingly common life-threatening allergic reaction. Patients at risk of anaphylaxis are prescribed epinephrine auto-injectors and play a crucial role in delivering their own care and management of this condition. One key recommendation is that patients routinely carry an epinephrine auto-injector with them and deploy the device when needed. However, only a small proportion of patients that require epinephrine actually receive it.

Objective:? To explore the reasons why patients who have been prescribed epinephrine auto-injectors fail to adhere to self-care and management recommendations.

Methods:? In-depth interviews with 15 adults who have been prescribed epinephrine auto-injectors were carried out to explore the barriers that exist in the provision of effective self-care and management of anaphylaxis.

Results:? Inconsistent health professional advice, perceived stigma of carrying a ‘weapon-like’ device, poor device design and limited patient training were identified as barriers to carriage or use. Patients were reluctant to carry devices in public because of perceived and observed stigma and suspicion. They were happy to ignore expiry dates, and some participants were confident that the emergency services would provide them with the appropriate care they needed, and therefore, did not carry the device in urban areas.

Conclusions and clinical implications:? Improved training of patients, the public and health professionals around both the carriage and use of auto-injectors are areas for urgent attention if improved levels of self-care are to be attained. The design of epinephrine auto-injectors should also receive attention as patients often fail to carry them owing to size and aesthetics.
adherence, allergy, anaphylaxis, empowerment, epinephrine, self-care, self-management, patient perspectives
0283-9318
Money, Arthur G
b6c22b4f-8152-4a3a-9f5c-787569ad2d1b
Barnett, Julie
e075f8d9-cf31-4bfc-a6be-41988b5ce764
Kuljis, Jasna
ad3e1fc8-8aa3-4ca7-a35f-fcf48bb37564
Lucas, Jane
5cb3546c-87b2-4e59-af48-402076e25313
Money, Arthur G
b6c22b4f-8152-4a3a-9f5c-787569ad2d1b
Barnett, Julie
e075f8d9-cf31-4bfc-a6be-41988b5ce764
Kuljis, Jasna
ad3e1fc8-8aa3-4ca7-a35f-fcf48bb37564
Lucas, Jane
5cb3546c-87b2-4e59-af48-402076e25313

Money, Arthur G, Barnett, Julie, Kuljis, Jasna and Lucas, Jane (2012) Patient perceptions of epinephrine auto-injectors: exploring barriers to use. Scandinavian Journal of Caring Sciences. (doi:10.1111/j.1471-6712.2012.01045.x). (PMID:22834703)

Record type: Article

Abstract

Background:? In recent years, government initiatives have proposed that patient self-care should serve as a key resource in response to the anticipated increase in global demand for health care. However, if patients are to be empowered as self-carers, barriers to engagement must be identified and overcome. Anaphylaxis is an increasingly common life-threatening allergic reaction. Patients at risk of anaphylaxis are prescribed epinephrine auto-injectors and play a crucial role in delivering their own care and management of this condition. One key recommendation is that patients routinely carry an epinephrine auto-injector with them and deploy the device when needed. However, only a small proportion of patients that require epinephrine actually receive it.

Objective:? To explore the reasons why patients who have been prescribed epinephrine auto-injectors fail to adhere to self-care and management recommendations.

Methods:? In-depth interviews with 15 adults who have been prescribed epinephrine auto-injectors were carried out to explore the barriers that exist in the provision of effective self-care and management of anaphylaxis.

Results:? Inconsistent health professional advice, perceived stigma of carrying a ‘weapon-like’ device, poor device design and limited patient training were identified as barriers to carriage or use. Patients were reluctant to carry devices in public because of perceived and observed stigma and suspicion. They were happy to ignore expiry dates, and some participants were confident that the emergency services would provide them with the appropriate care they needed, and therefore, did not carry the device in urban areas.

Conclusions and clinical implications:? Improved training of patients, the public and health professionals around both the carriage and use of auto-injectors are areas for urgent attention if improved levels of self-care are to be attained. The design of epinephrine auto-injectors should also receive attention as patients often fail to carry them owing to size and aesthetics.

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More information

e-pub ahead of print date: 27 July 2012
Keywords: adherence, allergy, anaphylaxis, empowerment, epinephrine, self-care, self-management, patient perspectives
Organisations: Clinical & Experimental Sciences

Identifiers

Local EPrints ID: 344357
URI: http://eprints.soton.ac.uk/id/eprint/344357
ISSN: 0283-9318
PURE UUID: b20d561d-0c98-4429-881b-039b126dfc78
ORCID for Jane Lucas: ORCID iD orcid.org/0000-0001-8701-9975

Catalogue record

Date deposited: 19 Oct 2012 14:49
Last modified: 15 Mar 2024 03:12

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Contributors

Author: Arthur G Money
Author: Julie Barnett
Author: Jasna Kuljis
Author: Jane Lucas ORCID iD

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