Study Finds Supervised Self-Injection With Empty Syringes Improved Comfort in Food-Allergic Adolescents Administering Epinephrine
Researchers from the Icahn School of Medicine at Mount Sinai have found that supervised self-injection with empty syringes makes many food-allergic adolescents and their parents more comfortable with using the life-saving devices. The results were published on March 7 in The Journal of Allergy and Clinical Immunology: In Practice.
Eighty-three percent of the teenagers in the first-of-its-kind, randomized controlled study and 88 percent of parents, described the intervention as beneficial. Seventy percent of the youths said the intervention helped improve their ability to self-inject. The intervention may translate into significant clinical benefits.
Nearly 6 million children have food allergies in the United States. While deaths from anaphylaxis, a severe allergic reaction that causes shortness of breath, vomiting, and lightheadedness are uncommon, they occur most often in adolescents and young adults, particularly in reaction to peanuts and tree nuts. Epinephrine injections work to counteract the symptoms of anaphylaxis by opening airways and narrowing blood vessels. People with food allergies are advised to carry epinephrine auto-injectors with them at all times.
The authors’ previous studies found that adolescents are at risk for not carrying their self-injector, often because of anxiety about self-injection. Investigators used the frameworks of cognitive behavioral and exposure therapy and found that exposure to the stressor in a controlled setting alleviated patients’ stress.
“Many adolescent patients with food allergies experience needle phobia or anxiety about self-administering epinephrine,” said the study’s lead author, Eyal Shemesh, MD, Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai. “Although it’s a simple idea for teenagers to practice giving themselves an injection to make themselves feel comfortable, this could lead to them being confident enough to take a life-saving action using epinephrine down the road.” The study’s senior author is Scott Sicherer, MD, Professor of Pediatrics, Allergy and Immunology at the Icahn School of Medicine at Mount Sinai.
The study included 60 participants aged 13-17.5 years old who had previously been diagnosed with a food allergy, and who had been prescribed an auto-injector but had never used it. They were accompanied by a parent or guardian to their appointments, and participants completed self-report questionnaires about their or their child’s comfort with self-injection. Afterwards half of the participants injected themselves once with an empty syringe, supervised by a doctor. The other half functioned as the control group and received education about self-injection. The intervention group and control group participants answered the same set of questions after the injection and education, respectively. One month after the clinic visit, participants were mailed an identical follow-up questionnaire.
The study was funded as a part of the EMPOWER (Enhancing, Managing, and Promoting Well-being and Resiliency) program within The Elliot and Roslyn Jaffe Food Allergy Institute at the Icahn School of Medicine at Mount Sinai, and by the Jaffe Family Foundation, Vanech Family Foundation, and The Pine/Segal families.
About the Mount Sinai Health System
Mount Sinai Health System is one of the nation’s leading integrated academic health systems and one of the largest in the New York metropolitan area. Its comprehensive system includes seven hospitals, more than 400 outpatient practices, over 600 research and clinical laboratories, the Icahn School of Medicine at Mount Sinai, the Graduate School of Biomedical Sciences, and the Mount Sinai Phillips School of Nursing. Together, the Health System comprises approximately 48,000 employees, more than 9,000 physicians, and 8,600 nurses.
As a leading learning health system, Mount Sinai combines clinical expertise with scientific discovery to improve patient care while training the next generation of health care and biomedical leaders. The Health System provides care across every stage of life, from prenatal care through geriatrics, while advancing personalized medicine through artificial intelligence, data science, and biomedical research.
Mount Sinai is consistently recognized among the nation’s leading academic health systems for patient care, research, and education. The Mount Sinai Hospital is ranked No. 1 in New York by Newsweek and No. 5 on the magazine’s World’s Best Hospitals list. The Icahn School of Medicine at Mount Sinai ranks No. 11 among U.S. medical schools and No. 1 among freestanding medical schools for National Institutes of Health funding, reflecting the strength of its scientific enterprise and leadership in biomedical research.
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