The compliance and burden of treatment with the epinephrine auto-injector in food-allergic adolescents.
BACKGROUND
Food-allergic patients at high risk of potential fatal anaphylaxis should carry an epinephrine auto-injector (EAI) at all times. This treatment may be perceived as burdensome and this may affect compliance and health-related quality of life (HRQL). The aims of the study were (1) to determine the burden of treatment (BoT) of an EAI, (2) to examine the relationship between this burden and compliance, and (3) to analyze which factors contribute to the BoT of the EAI as perceived by food-allergic adolescents and their parents.


METHODS
Dutch food-allergic adolescents prescribed an EAI, and their parents completed a questionnaire package (n = 55). Relationships between BoT and HRQL, illness severity and perception, and anxiety measures were investigated.


RESULTS
Food-allergic adolescents and their parents were (extremely) positive about the EAI (54.5%; 72.7%, respectively) (=low BoT). The BoT measure showed a significantly greater burden in food-allergic adolescents prescribed an EAI who reported not carrying the EAI at all times than adolescents who reported they did. The BoT scores of both adolescents and their parents were not associated with HRQL, illness severity and perception, or trait anxiety.


CONCLUSIONS
The majority of food-allergic adolescents and their parents were positive about the EAI (=low BoT). However, the BoT was significantly associated with self-reported compliance with carrying the EAI. The BoT was higher in food-allergic adolescents prescribed an EAI who reported not carrying the EAI at all times. The BoT measure seems to be a useful tool to study compliance with carrying an EAI. The BoT of an EAI is not associated with HRQL. The BoT measures a distinct concept related to compliance behavior.
Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J
J
Saleh-Langenberg
GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
B M J
BM
Flokstra-de Blok
Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
N J
NJ
Goossens
Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J C
JC
Kemna
GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
J L
JL
van der Velde
Department of Pediatric Pulmonology and Pediatric Allergy, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.|GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
A E J
AE
Dubois
D000293:Adolescent; D000294:Adolescent Behavior; D000367:Age Factors; D018926:Anti-Allergic Agents / Q000008:administration & dosage*; D001007:Anxiety / Q000523:psychology; D017281:Cost of Illness; D004837:Epinephrine / Q000008:administration & dosage*; D005260:Female; D005512:Food Hypersensitivity / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007267:Injections; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009426:Netherlands; D010290:Parents / Q000523:psychology; D010465:Perception; D011788:Quality of Life; D012646:Self Administration; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D018926:Anti-Allergic Agents; D004837:Epinephrine
adolescents; burden of treatment; compliance; epinephrine auto-injector; food allergy