title: Key components of anaphylaxis management plans: consensus findings from a national electronic Delphi study.
abstract: OBJECTIVE
  There is no international consensus on the components of anaphylaxis management plans and responsibility for their design and delivery is contested. We set out to establish consensus among relevant specialist and generalist clinicians on this issue to inform future randomized controlled trials.
  
  
  METHODS
  A two-round electronic Delphi study completed by a 25-person, multidisciplinary expert panel. Participants scored the importance of a range of statements on anaphylaxis management, identified from a systematic review of the literature, on a five-point scale ranging from 'very important' to 'irrelevant'. Consensus was defined a priori as being achieved if 80% or more of panel members rated a statement as 'important' or 'very important' after Round 2.
  
  
  METHODS
  Primary and secondary care and academic settings in the UK and Ireland.
  
  
  METHODS
  Twenty-five medical, nursing and allied health professionals.
  
  
  METHODS
  Consensus on the key components of anaphylaxis management plans.
  
  
  RESULTS
  The response rate was 84% (n = 21) for Round 1 and 96% (n = 24) for Round 2. The key components of emergency care on which consensus was achieved included: awareness of trigger factors (100%); recognition and emergency management of reactions of different severity (100%); and clear information on adrenaline (epinephrine) use (100%). Consensus on longer-term management issues included: clear written guidelines on anaphylaxis management (96%); annual review of plans (87%); and plans that were tailored to individual needs (82%).
  
  
  CONCLUSIONS
  This national consensus-building exercise generated widespread agreement that emergency plans need to be simple, clear and generic, making them easy to implement in a crisis. In contrast, long-term plans need to be negotiated between patient/carers and professionals, and tailored to individual needs. The effectiveness of this expert-agreed long-term plan now needs to be evaluated rigorously.
authors.affiliation: Allergy & Respiratory Research Group, Centre for Population Health Sciences: General Practice Section, The University of Edinburgh, Medical School , Teviot Place, Edinburgh EH8 9AG , UK.
authors.forename: Allison
authors.initials: A
authors.lastname: Worth
authors.forename: Ulugbek
authors.initials: U
authors.lastname: Nurmatov
authors.forename: Aziz
authors.initials: A
authors.lastname: Sheikh