Carrying an adrenaline auto injector (AAI) (an EpiPen or Anapen), as a treatment for food allergy, can have a detrimental effect on a child’s quality of life, independent of other factors that can also impact on quality of life such as whether they have previously suffered anaphylaxis.
Researchers at Murdoch Childrens Research Institute, questioned mothers of children who had food allergies and found that being allergic to four or more foods, being an older child (aged seven to 12 years old as compared to under seven) and having had anaphylaxis previously were associated with a poorer quality of life.
However, they also found that carrying an AAI was associated with a poorer quality of life independent of these other factors.
A/Professor Mimi Tang says the study showed providing patients with an Epipen can have an impact on the child’s quality of life, and this should be taken into consideration when deciding who should be prescribed an AAI.
“Our results showed that when managing children with food allergy, it is very important to weigh up the pros and cons of recommending an adrenaline auto injector. Not every child with food allergy will benefit from having one – most will never have a severe allergic reaction,” Mimi said.
“We don’t know if the reduced quality of life relates to being prescribed an adrenaline auto- injector or having to carry one- likely both. However, if one is prescribed, there should be careful education on how and when to use it, to minimise the negative impact on quality of life.”
Mimi said current practice regarding prescribing an AAI varies widely, with some doctors prescribing them to all children with a food allergy, including those who have not had a previous allergic reaction to that food (but had a positive skin prick test).
Australian prescribing guidelines recommend an adrenaline auto injector for those children who’ve experienced anaphylaxis and those with systemic reactions who also have risk factors for more severe or fatal anaphylaxis, for example poorly controlled asthma, teenagers and young adults, those in a remote location, and nut allergies.