Relevance of the Self-assessment of Skills for Self-administration of Adrenaline by Auto-injectors in Patients at Risk of Severe Anaphylactic Reaction (PacAdré)
Study Details
Study Description
Brief Summary
To investigate the correlation between self-assessment by patients and an assessment by a health professional of the skills needed for self administration of adrenaline by auto-injectors. These skills include the identification of situations requiring the administration of adrenaline and the technical abilities to achieve it.
Hypothesis:
A self-assessment correlated with an external assessment would make it easier to adjust the frequency of therapeutic education sessions based on the patient's self-assessment alone.
Condition or Disease | Intervention/Treatment | Phase |
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Detailed Description
Intramuscular Adrenaline is the standard treatment for severe to moderate anaphylaxis. Self-administration of Adrenaline by the patient using an auto-injector pen in case of anaphylaxis is a major axis of management of patients with severe food allergy, hymenoptera venom allergy or systemic mastocytosis. This self-administration skill requires prior therapeutic education of the patient. This education must be repeated over time and must include two components: the identification of anaphylactic situations requiring the self-administration of Adrenalin and the technical skills and abilities to carry out this self-injection.
Numerous studies have investigated the technical skills for using Adrenaline auto-injector pens according to the device prescribed, the importance of therapeutic education, the optimal frequency of therapeutic education sessions for self-administration and the main barriers to the use of Adrenaline.
To our knowledge, no study has investigated the correlation between patients' self-assessment of the skills required for self-administration of Adrenaline by self-injecting pen and an external assessment of these same skills by a health professional.
A self-assessment correlated with an external assessment would make it easier to adjust the frequency of therapeutic education sessions based on patient self-assessment alone.
Study Design
Outcome Measures
Primary Outcome Measures
- Correlation between a patient self-assessment and a health care professional's assessment of the skills needed to self-administer epinephrine by self-injecting pen [One day]
A two-part, 20-point self-assessment scale: A visual analog scale addressing skills in identifying situations requiring administration of self-injectable epinephrine, scored out of 10 points A visual analogue scale for technical skills in administering epinephrine by self-injecting pen, scored out of 10 points A two-part health professional assessment scale scored out of 20 points: A single response questionnaire asked to the patient including 5 standardized clinical situations, validated by an expert committee, requiring or not the administration of Adrenalin, scored out of 10 points An evaluation of the technical skills of injecting adrenaline with a self-injecting pen with a demonstration pen, in 6 steps, scored out of 10 points
Secondary Outcome Measures
- Correlation between patient self-assessment and healthcare professional assessment of ability to identify situations requiring administration of self-injectable epinephrine [One day]
A 10-point self-assessment scale in the form of a visual analogue scale on the ability to identify situations requiring the administration of self-injectable epinephrine and a hetero-assessment with a 10-point single-answer questionnaire including 5 standardized clinical situations, validated by an expert committee, requiring or not the administration of adrenaline
- Correlation between a patient's self-assessment and a healthcare professional's assessment of technical skills in performing epinephrine administration by self-injecting pen [One day]
A 10-point self-assessment scale in the form of a visual analog scale of technical skills in performing epinephrine administration by self-injecting pen and a 10-point hetero-assessment of epinephrine injection skills by self-injecting pen with a 6-step demonstration pen.
Eligibility Criteria
Criteria
Inclusion Criteria:
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Adult patient
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Follow-up at the CHU Grenoble Alpes or at the CH Métropole Savoie with at least one consultation every 2 years
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With a pathology at risk of severe anaphylaxis:
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Severe food allergy and/or,
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Allergy to wasp venom and/or
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Systemic mastocytosis
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With a current adrenaline prescription that is more than a year old
Exclusion Criteria:
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Patient with a pathology at risk of severe anaphylaxis not identified in the inclusion criteria (isolated drug allergy, idiopathic anaphylaxis, etc.)
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Patient with cognitive or memory disorders
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Patient not speaking French or with a limited understanding of the language
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Patient not affiliated to a social security scheme
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Refusal of the patient to participate in the research or inability of the patient to give his consent
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Patient under guardianship or subject deprived of liberty
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- University Hospital, Grenoble
Investigators
- Principal Investigator: Alexis BOCQUET, Md, CHU Grenoble Alpes
Study Documents (Full-Text)
None provided.More Information
Additional Information:
Publications
- Bilò MB, Cichocka-Jarosz E, Pumphrey R, Oude-Elberink JN, Lange J, Jakob T, Bonadonna P, Fernandez J, Kosnik M, Helbling A, Mosbech H, Gawlik R, Niedoszytko M, Patella V, Pravettoni V, Rodrigues-Alves R, Sturm GJ, Rueff F. Self-medication of anaphylactic reactions due to Hymenoptera stings-an EAACI Task Force Consensus Statement. Allergy. 2016 Jul;71(7):931-43. doi: 10.1111/all.12908. Epub 2016 Apr 29. Review.
- Broesby-Olsen S, Dybedal I, Gülen T, Kristensen TK, Møller MB, Ackermann L, Sääf M, Karlsson MA, Agertoft L, Brixen K, Hermann P, Stylianou E, Mortz CG, Torfing T, Havelund T, Sander B, Bergström A, Bendix M, Garvey LH, Bjerrum OW, Valent P, Bindslev-Jensen C, Nilsson G, Vestergaard H, Hägglund H. Multidisciplinary Management of Mastocytosis: Nordic Expert Group Consensus. Acta Derm Venereol. 2016 Jun 15;96(5):602-12. doi: 10.2340/00015555-2325.
- Muraro A, Werfel T, Hoffmann-Sommergruber K, Roberts G, Beyer K, Bindslev-Jensen C, Cardona V, Dubois A, duToit G, Eigenmann P, Fernandez Rivas M, Halken S, Hickstein L, Høst A, Knol E, Lack G, Marchisotto MJ, Niggemann B, Nwaru BI, Papadopoulos NG, Poulsen LK, Santos AF, Skypala I, Schoepfer A, Van Ree R, Venter C, Worm M, Vlieg-Boerstra B, Panesar S, de Silva D, Soares-Weiser K, Sheikh A, Ballmer-Weber BK, Nilsson C, de Jong NW, Akdis CA; EAACI Food Allergy and Anaphylaxis Guidelines Group. EAACI food allergy and anaphylaxis guidelines: diagnosis and management of food allergy. Allergy. 2014 Aug;69(8):1008-25. doi: 10.1111/all.12429. Epub 2014 Jun 9.
- Pumphrey RS. Lessons for management of anaphylaxis from a study of fatal reactions. Clin Exp Allergy. 2000 Aug;30(8):1144-50. Review.
- Ridolo E, Montagni M, Bonzano L, Savi E, Peveri S, Costantino MT, Crivellaro M, Manzotti G, Lombardi C, Caminati M, Incorvaia C, Senna G. How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients. Intern Emerg Med. 2015 Dec;10(8):937-41. doi: 10.1007/s11739-015-1255-z. Epub 2015 May 20.
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- Shemesh E, D'Urso C, Knight C, Rubes M, Picerno KM, Posillico AM, Atal Z, Annunziato RA, Sicherer SH. Food-Allergic Adolescents at Risk for Anaphylaxis: A Randomized Controlled Study of Supervised Injection to Improve Comfort with Epinephrine Self-Injection. J Allergy Clin Immunol Pract. 2017 Mar - Apr;5(2):391-397.e4. doi: 10.1016/j.jaip.2016.12.016. Epub 2017 Jan 20.
- Simons FE, Ardusso LR, Bilò MB, El-Gamal YM, Ledford DK, Ring J, Sanchez-Borges M, Senna GE, Sheikh A, Thong BY; World Allergy Organization. World Allergy Organization anaphylaxis guidelines: summary. J Allergy Clin Immunol. 2011 Mar;127(3):587-93.e1-22. doi: 10.1016/j.jaci.2011.01.038.
- Sirin Kose S, Asilsoy S, Tezcan D, Al S, Atay O, Kangalli O, Uzuner N, Karaman O. Is There an Optimal Training Interval to Improve the Correct Use of Adrenaline Auto-Injectors? Int Arch Allergy Immunol. 2020;181(2):136-140. doi: 10.1159/000504365. Epub 2019 Dec 3.
- Song TT, Worm M, Lieberman P. Anaphylaxis treatment: current barriers to adrenaline auto-injector use. Allergy. 2014 Aug;69(8):983-91. doi: 10.1111/all.12387. Epub 2014 May 16. Review.
- Topal E, Bakirtas A, Yilmaz O, Ertoy IH, Arga M, Demirsoy MS, Turktas I. A real-life study on acquired skills from using an adrenaline autoinjector. Int Arch Allergy Immunol. 2013;160(3):301-6. doi: 10.1159/000341367. Epub 2012 Oct 18.
- Yu JE, Lin RY. The Epidemiology of Anaphylaxis. Clin Rev Allergy Immunol. 2018 Jun;54(3):366-374. doi: 10.1007/s12016-015-8503-x. Review.
- 38RC22.0156