title: Epinephrine auto-injector prescriptions to food-allergic patients in primary care in The Netherlands.
abstract: BACKGROUND
  The knowledge of general practitioner(s) (GPs) regarding food allergy and anaphylaxis and practices in the prescription of epinephrine auto-injector(s) (EAIs) among GPs has previously only been studied using questionnaires and hypothetical cases. Therefore, there are currently no data as to whether or not GPs prescribe EAIs to high risk food-allergic patients presenting to primary care practices. The aim of this study was therefore to describe and evaluate practice in EAI prescription by GPs to food-allergic patients in The Netherlands.
  
  
  METHODS
  Patients aged 12-23 years who consulted their GP for allergic symptoms were identified in a primary care database. Patients were classified as probably or unlikely to be food-allergic. A risk factor assessment was done to identify probably food-allergic patients at high risk for anaphylaxis to assess the need for an EAI.
  
  
  RESULTS
  One hundred forty-eight out of 1015 patients consulted their GP for allergic symptoms due to food. Eighty patients were excluded from analysis because of incomplete records. Thirty-four patients were classified as probably food-allergic. Twenty-seven of them were considered high risk patients and candidates for an EAI. Importantly, only 10 of them had actually been prescribed an EAI by their GP.
  
  
  CONCLUSIONS
  This study shows that high risk food-allergic patients that visit their GPs are often not prescribed an EAI. Thus, previously identified low rates of EAI ownership may be partly due to GPs not prescribing this medication to patients for whom it would be appropriate to do so. These data suggest that there is a need for improvement of the quality of care for high risk food-allergic patients in primary care.
authors.affiliation: Department of Pediatric Pulmonology and Pediatric Allergy, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands ; GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Jacquelien
authors.initials: J
authors.lastname: Saleh-Langenberg
authors.affiliation: Department of Pediatric Pulmonology and Pediatric Allergy, University Medical Centre Groningen, University of Groningen, P.O. Box 30.001, 9700 RB Groningen, The Netherlands ; GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: A E J
authors.initials: AE
authors.lastname: Dubois
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Groenhof
authors.affiliation: GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands ; Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: J W H
authors.initials: JW
authors.lastname: Kocks
authors.affiliation: GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands ; Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: T
authors.initials: T
authors.lastname: van der Molen
authors.affiliation: GRIAC Research Institute, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands ; Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: B M J
authors.initials: BM
authors.lastname: Flokstra-de Blok
keywords: Anaphylaxis; Epinephrine auto-injector; Food allergy; General practitioner; Primary care