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New Research - March 2010
Gaps in the care of patients with anaphylaxis
Summary
The authors systematically reviewed the literature summarizing studies investigating gaps in anaphylaxis management. They looked at Medline, EMBASE, CINAHL, and evidence-based medical reviews. They looked at 5,014 citations and identified 15 studies that met their inclusion criteria.
They found that there were gaps in the knowledge of utilization of automatic epinephrine injectors both in regards to physicians and patients. They also found that there were errors in the administration of epinephrine. There was failure to use this drug as well as delays in the administration. They noted that diagnostic errors occurred because of the lack of appropriate diagnostic codes. The rate of autoinjector prescriptions was found to be lower than appropriate. The regular referral to allergists was found to be less than appropriate. Seven studies found that patients did not maintain autoinjectors on their person. There were gaps in the use of autoinjectors in schools.
In summary, the authors found 202 "gaps" in the appropriate management of anaphylaxis. They were related to gaps in knowledge as well as adherence to instructions, and failure to give adequate instructions. They hope to use this knowledge in constructing interventional strategies.
Reference
Kastner M, et al. Gaps in anaphylaxis management at the level of physicians, patients, and the community: a systematic review of the literature. Allergy 2009; 65(4):435-444.
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