The importance of in-date Adrenaline Auto-Injectors in managing patients at risk of anaphylaxis

Anaphylaxis is the most severe presentation of an allergic reaction and according to MHRA data, in the period of 2022 and 2023, there were 25,721 admissions to English hospitals for allergies and anaphylaxis – more than double the 12,361 recorded two decades before.  It’s widely accepted that the prevalence of allergies is on the rise, and whilst the deaths from anaphylaxis are thankfully declining, the importance of promoting preventative allergy management is crucial to maintaining this trajectory.  Healthcare professionals can play a very active role in ensuring patients are compliant with their preventative allergy management regime. One essential part of this is use of their prescribed AAI medical device. 

The Importance of In-Date AAIs and training patients how to check for expiry dates. 

Effectiveness and Safety: Adrenaline is the most effective first line treatment when someone is having an anaphylactic reaction. Recognition of symptoms and prompt use of adrenaline is of vital importance to save life. Adrenaline is most effective when it is in date and not deteriorated. Expired AAIs may degrade over time and so may not be effective. This may risk inadequate treatment during anaphylaxis.

Patient Confidence: Recent Allergy UK patient data underscores the heavy psychological impact and mental health burden of living with allergies. Of the people living with food allergies we surveyed, 20% said they lived in fear of an anaphylactic event. Up to date and access to AAIs instills confidence in patients that they have a reliable emergency treatment and helps to reduce this anxiety about potential anaphylactic episodes. 

Easy ways Healthcare Professionals can support their patients 

1. It is imperative that all patients who have been assessed as at risk of anaphylaxis are prescribed two AAIs. This is irrespective of age, triggers for anaphylaxis or anything else. MHRA guidelines are that a patient who has had an anaphylaxis diagnosis must have a prescription for two AAIs.
2. Train patients how to use their AAI and ideally Conduct regular reviews of patient records to track AAI expiration dates.  If it is not possible to undertake a specific AAI review of all patient records on a regular basis, ensure that any patient contact is an opportunity for a healthcare professional to double check if someone has all the necessary, in date prescriptions they require to help manage their allergies. 
3. Educate patients on ways they can also proactively manage their emergency allergy medication. Encourage them to use the alert services offered by the AAI providers for reminders on when to renew their AAI prescription. Remind them that there are now digital tools such as repeat prescription services, online pharmacies and if available, the choice of prescriptions going directly to a local chemist to make collecting their AAIs as accessible as possible.  Also, direct them to online how to guides on using their AAI, so they are confident in using an AAI if necessary. Allergy UK also offers information to patients on how to be AAI ready here.

Healthcare professionals play a vital role in ensuring that patients at risk of anaphylaxis have up-to-date AAIs. By following the NICE guidelines, including patient education, regular monitoring, and utilizing technology, professionals can help prevent anaphylactic emergencies and improve patient outcomes. Continuous engagement and proactive management are key to maintaining the efficacy and reliability of these life-saving devices.  

For more detailed information on managing Anaphylaxis, refer to the NICE guidelines here.