From prescription to preparedness: Barriers to anaphylaxis management across home, school, and clinic De la prescription à la préparation : obstacles à la prise en charge de l'anaphylaxie à domicile, à l’école et en consultation
Revue Francaise d'Allergologie, cilt.66, sa.5, 2026 (SCI-Expanded, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 66 Sayı: 5
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.reval.2026.105037
- Dergi Adı: Revue Francaise d'Allergologie
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE
- Anahtar Kelimeler: Anaphylaxis, Epinephrine auto-injector, Pediatrics, School preparedness, Caregiver carriage, Adolescent self-efficacy, Training, Emergency management, Legal concerns, Guideline implementation
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Real-world preparedness for pediatric anaphylaxis often remains inadequate across home, school, and clinic settings despite guidelines. This study aimed to evaluate barriers to anaphylaxis management across the home–school–clinic triad in children prescribed epinephrine auto-injectors, focusing on caregiver competence, adolescent self-efficacy, and school preparedness. Methods: This single-center cross-sectional study enrolled 125 pediatric patients with physician-diagnosed anaphylaxis and an active epinephrine auto-injector prescription. Parents/caregivers were interviewed during follow-up visits, and device availability at the visit was verified. Adolescents aged 12 years or older and teachers of school-attending children were interviewed. After a standardized demonstration using a training device, parents and adolescents rated confidence on a 5-point scale, and teachers reported willingness to administer epinephrine. Clinical data were retrieved from medical records. Results: Post-diagnosis anaphylactic episodes occurred in 52/125 patients (41.6%), yet epinephrine was administered in only 10/52 episodes (19.2%). Although 60.8% of caregivers reported “always” carrying the device, it was available at the clinic visit in only 50/125 patients (40.0%). Most caregivers had training (92%), yet 71.3% last trained over a year ago. After demonstration, 50.4% of parents versus 16.7% of adolescents reported confident administration. In schools, 93.6% of teachers had no prior training, and 74.6% did not identify epinephrine as first-line treatment. After demonstration, 36.7% would administer confidently, while 25.3% would refrain due to legal concerns. Conclusion: Epinephrine auto-injector prescription did not ensure preparedness. Low carriage, reduced adolescent self-efficacy, and substantial school-level knowledge and implementation barriers highlight the need for repeated practical training and clearer institutional procedures.