More Than Half of US Adults Who Are Prescribed Epinephrine Don’t Use It in an Emergency

By Sondra Forsyth

The most effective, life-saving treatment for a severe allergic reaction (anaphylaxis) is epinephrine. Yet a 2018 study showed that in an emergency, 52 percent of adults with potentially life-threatening allergies didn’t use the epinephrine auto-injectors (EAI), also called epi pens, which they were prescribed.

The study, published in June in Annals of Allergy, Asthma and Immunology, the scientific journal of the American College of Allergy, Asthma and Immunology (ACAAI), examined 597 surveys representing 917 people. Some adults provided information both for themselves and their children with an EAI prescription.

A release from ACAAI quotes Christopher Warren, PhD(c), lead author of the study, as saying, “The majority of people surveyed (89 percent) filled the prescriptions they were given for an EAI. But almost half (45 percent) said they didn’t have their EAI with them during their most severe allergic reaction. This was despite the fact that 78 percent of the people responding had been hospitalized for their allergy at some point in their lifetime. Another 21 percent said they didn’t know how to use their EAI.”

ACAAI recommends that anyone who has been prescribed an EAI should always have it with them and that they should always carry two as the possibility exists that a severe reaction can reoccur. Moreover, epinephrine should be administered at the first sign of an anaphylactic reaction. This is particularly important for those who have had a previous anaphylactic reaction or who have both a severe allergy and asthma.

“It’s not enough to simply pick up your EAI prescription,” says Ruchi Gupta, MD, MPH, ACAAI member, and co-author of the study. “You need to know how to use your EAI and always carry it, to be prepared for an allergy emergency. It could save your life.” About half the survey participants said an EAI was accessible (within five minutes) all of the time, while 44 percent said they personally carried at least one EAI all the time. Fewer than 25 percent of those surveyed said they routinely carried multiple EAIs.

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If you are unsure of how to use your EAI, talk to your allergist and ask them to walk you through the steps for use. To find an allergist near you who can help create a personal plan to deal with your severe allergies, use the ACAAI allergist locator.

Watch ACAAI’s YouTube video – featuring Dr. Gupta – on why it’s important not to fear epinephrine, as well as a video on how to use an EAI.