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Article: Hong Kong Anaphylaxis Consortium Consensus Statements on prescription of adrenaline autoinjectors in the acute care setting

TitleHong Kong Anaphylaxis Consortium Consensus Statements on prescription of adrenaline autoinjectors in the acute care setting
Authors
KeywordsAdrenaline
Anaphylaxis
Autoinjector
Consensus
Consortium
Issue Date2021
PublisherAsia Pacific Association of Allergy, Asthma and Clinical Immunology. The Journal's web site is located at http://www.apallergy.org/
Citation
Asia Pacific Allergy, 2021, v. 11 n. 1, p. article no. e1 How to Cite?
AbstractBackground: Adrenaline autoinjectors (AAInj) facilitates early administration of adrenaline and remains the first-line treatment for anaphylaxis. However, only a minority of anaphylaxis survivors in Hong Kong are prescribed AAInj and formal guidance do not exist. International anaphylaxis guidelines have been largely based on Western studies, which may not be as relevant for non-Western populations. Objective: To formulate a set of consensus statements on the prescription of AAInj in Hong Kong. Methods: Consensus statements were formulated by the Hong Kong Anaphylaxis Consortium by the Delphi method. Agreement was defined as greater than or equal to 80% consensus. Subgroup analysis was performed to investigate differences between allergy and emergency medicine physicians. Results: A total of 7 statements met criteria for consensus with good overall agreement between allergy and emergency medicine physicians. AAInj should be used as first-line treatment and prescribed for all patients at risk of anaphylaxis. This should be prescribed prior to discharge from the Accident and Emergency Department together with an immediate referral to an allergy center. The decision for prescribing AAInj should be based on the severity of previous reactions; including objective signs of respiratory involvement, objective signs of cardiovascular involvement and multiorgan involvement (regardless of severity). Patient demographics and comorbidities, specifically history of asthma or chronic obstructive pulmonary disease, should also be considered. Patients deemed eligible for AAInj should be offered avoidance advice and prescribed one AAInj while awaiting review by allergists. AAInj technique should be demonstrated by a healthcare professional or instruction video, and a return demonstration by the patient is required. The patient should also be counseled that the decision on the continued need of AAInj prescription in the long-term should be reviewed by an allergist. Conclusion: Consensus statements support the prescription of AAInj by front-line physicians with subsequent allergist review when treating patients at risk of anaphylaxis in Hong Kong.
Persistent Identifierhttp://hdl.handle.net/10722/302384
ISSN
2020 SCImago Journal Rankings: 0.179
PubMed Central ID
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorLi, PH-
dc.contributor.authorChua, GT-
dc.contributor.authorLeung, ASY-
dc.contributor.authorChan, YC-
dc.contributor.authorChan, KKL-
dc.contributor.authorCheung, KH-
dc.contributor.authorChong, PCY-
dc.contributor.authorHo, PPK-
dc.contributor.authorKwan, MYW-
dc.contributor.authorLai, JCH-
dc.contributor.authorLam, KK-
dc.contributor.authorLam, TSK-
dc.contributor.authorLeung, TF-
dc.contributor.authorLi, TY-
dc.contributor.authorDuque, JSR-
dc.contributor.authorSo, JLT-
dc.contributor.authorWan, KA-
dc.contributor.authorWong, HCY-
dc.contributor.authorWu, AYY-
dc.contributor.authorLee, TH-
dc.contributor.authorHo, MHK-
dc.contributor.authorSiu, AYC-
dc.date.accessioned2021-09-06T03:31:31Z-
dc.date.available2021-09-06T03:31:31Z-
dc.date.issued2021-
dc.identifier.citationAsia Pacific Allergy, 2021, v. 11 n. 1, p. article no. e1-
dc.identifier.issn2233-8276-
dc.identifier.urihttp://hdl.handle.net/10722/302384-
dc.description.abstractBackground: Adrenaline autoinjectors (AAInj) facilitates early administration of adrenaline and remains the first-line treatment for anaphylaxis. However, only a minority of anaphylaxis survivors in Hong Kong are prescribed AAInj and formal guidance do not exist. International anaphylaxis guidelines have been largely based on Western studies, which may not be as relevant for non-Western populations. Objective: To formulate a set of consensus statements on the prescription of AAInj in Hong Kong. Methods: Consensus statements were formulated by the Hong Kong Anaphylaxis Consortium by the Delphi method. Agreement was defined as greater than or equal to 80% consensus. Subgroup analysis was performed to investigate differences between allergy and emergency medicine physicians. Results: A total of 7 statements met criteria for consensus with good overall agreement between allergy and emergency medicine physicians. AAInj should be used as first-line treatment and prescribed for all patients at risk of anaphylaxis. This should be prescribed prior to discharge from the Accident and Emergency Department together with an immediate referral to an allergy center. The decision for prescribing AAInj should be based on the severity of previous reactions; including objective signs of respiratory involvement, objective signs of cardiovascular involvement and multiorgan involvement (regardless of severity). Patient demographics and comorbidities, specifically history of asthma or chronic obstructive pulmonary disease, should also be considered. Patients deemed eligible for AAInj should be offered avoidance advice and prescribed one AAInj while awaiting review by allergists. AAInj technique should be demonstrated by a healthcare professional or instruction video, and a return demonstration by the patient is required. The patient should also be counseled that the decision on the continued need of AAInj prescription in the long-term should be reviewed by an allergist. Conclusion: Consensus statements support the prescription of AAInj by front-line physicians with subsequent allergist review when treating patients at risk of anaphylaxis in Hong Kong.-
dc.languageeng-
dc.publisherAsia Pacific Association of Allergy, Asthma and Clinical Immunology. The Journal's web site is located at http://www.apallergy.org/-
dc.relation.ispartofAsia Pacific Allergy-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectAdrenaline-
dc.subjectAnaphylaxis-
dc.subjectAutoinjector-
dc.subjectConsensus-
dc.subjectConsortium-
dc.titleHong Kong Anaphylaxis Consortium Consensus Statements on prescription of adrenaline autoinjectors in the acute care setting-
dc.typeArticle-
dc.identifier.emailLi, PH: liphilip@hku.hk-
dc.identifier.emailChua, GT: cgt560@hku.hk-
dc.identifier.authorityLi, PH=rp02669-
dc.identifier.authorityChua, GT=rp02684-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.5415/apallergy.2021.11.e1-
dc.identifier.pmid33604271-
dc.identifier.pmcidPMC7870372-
dc.identifier.hkuros324759-
dc.identifier.volume11-
dc.identifier.issue1-
dc.identifier.spagearticle no. e1-
dc.identifier.epagearticle no. e1-
dc.identifier.isiWOS:000614559500001-
dc.publisher.placeRepublic of Korea-

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