Epinephrine autoinjector prescription patterns for severe anaphylactic patients in Japan: A retrospective analysis of health insurance claims data

Allergology International

Yoshihiro Yamaguchi¹  Richard H. Kaszynski²  Sachiko Ono³  Nobuaki Michihata⁴  Hiroki Matsui⁵  Hideo Yasunaga⁶  Mikio Nakajima⁷ 

[1] Bioinformatics, The University of Tokyo, Tokyo, Japan;Corresponding author. Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, 2−34−10, Ebisu, Shibuya-ku, Tokyo, 150-0013, Japan.;Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan;Department of Trauma and Critical Care Medicine, Kyorin University School of Medicine, Tokyo, Japan;;Department of Biostatistics &Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan;Emergency and Critical Care Center, Tokyo Metropolitan Hiroo Hospital, Tokyo, Japan;

关键词: Anaphylaxis;    Epinephrine autoinjector;    Refill;    Self-inject epinephrine;    Self-treatment;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Current guidelines recommend that any patient who has experienced anaphylaxis should be prescribed one or more epinephrine autoinjectors (EAI) for immediate self-treatment. However, the etiology of anaphylaxis and prescription patterns of EAI have not been widely examined in Japan. Methods: This was a retrospective cohort study using a large Japanese claims database (JMDC, Tokyo, Japan). We included patients with severe anaphylaxis who received epinephrine in a hospital or outpatient clinic from 2011 to 2016. We extracted patients who were prescribed EAIs and examined the annual trend of EAI prescription rates and refill patterns. Results: We identified 1255 eligible patients. Among them, 361 patients (28.8%) were prescribed EAIs within 30 days after their initial severe anaphylactic episode. In patients who were prescribed EAIs, 65.9% were prescribed EAIs from the same facility in which initial treatment was given for severe anaphylaxis. The prescription rates of EAI significantly increased from 11.1% in 2011 to 30.9% in 2016. Among patients with initial EAI prescriptions, 97.3% refilled their EAI prescriptions at least once and 40.5% refilled their prescriptions annually during the 3 year follow up period. Conclusions: EAI prescription rates were relatively low in patients who experienced severe anaphylaxis in Japan. Physicians should prescribe EAIs to all patients who were treated for anaphylaxis under their care and avoid delegating the responsibility of prescribing EAIs to other facilities. Initial prescription of EAIs can result in improved regular refill and dissemination practices.

【 授权许可】

Unknown