title: What factors affect the carriage of epinephrine auto-injectors by teenagers?
abstract: BACKGROUND
  Teenagers with allergies are at particular risk of severe and fatal reactions, but epinephrine auto-injectors are not always carried as prescribed. We investigated barriers to carriage.
  
  
  METHODS
  Patients aged 12-18 years old under a specialist allergy clinic, who had previously been prescribed an auto-injector were invited to participate. Semi-structured interviews explored the factors that positively or negatively impacted on carriage.
  
  
  RESULTS
  Twenty teenagers with food or venom allergies were interviewed. Only two patients had used their auto-injector in the community, although several had been treated for severe reactions in hospital. Most teenagers made complex risk assessments to determine whether to carry the auto-injector. Most but not all decisions were rational and were at least partially informed by knowledge. Factors affecting carriage included location, who else would be present, the attitudes of others and physical features of the auto-injector. Teenagers made frequent risk assessments when deciding whether to carry their auto-injectors, and generally wanted to remain safe. Their decisions were complex, multi-faceted and highly individualised.
  
  
  CONCLUSIONS
  Rather than aiming for 100% carriage of auto-injectors, which remains an ambitious ideal, personalised education packages should aim to empower teenagers to make and act upon informed risk assessments.
authors.affiliation: Academic Unit of Clinical and Experimental Sciences, Faculty of Medicine, University of Southampton, Southampton, UK. jlucas1@soton.ac.uk.
authors.forename: Clare
authors.initials: C
authors.lastname: Macadam
authors.forename: Julie
authors.initials: J
authors.lastname: Barnett
authors.forename: Graham
authors.initials: G
authors.lastname: Roberts
authors.forename: Gary
authors.initials: G
authors.lastname: Stiefel
authors.forename: Rosemary
authors.initials: R
authors.lastname: King
authors.forename: Michel
authors.initials: M
authors.lastname: Erlewyn-Lajeunesse
authors.forename: Judith A
authors.initials: JA
authors.lastname: Holloway
authors.forename: Jane S
authors.initials: JS
authors.lastname: Lucas