Literature DB >> 20306821

A comparison of 4 epinephrine autoinjector delivery systems: usability and patient preference.

Stephanie Guerlain1, Akilah Hugine, Lu Wang.   

Abstract

BACKGROUND: Prefilled epinephrine autoinjectors are sometimes improperly used by patients, caregivers, and physicians. A user-centered design process led to the development of 2 prototype epinephrine autoinjectors (INT01 and INT02) that have a unidirectional perceived injection end, a self-retracting needle, and, with INT02, voice instructions to assist in guiding users through administration.
OBJECTIVE: To compare the usability and patient preference among 4 epinephrine autoinjectors: EpiPen, TwinJect, INT01, and INT02.
METHODS: A total of 48 participants were divided equally among 3 age groups: 7 to 10, 11 to 15, and 16 to 55 years. In each group, half had prior TwinJect or EpiPen training. In 1-hour sessions, without training, participants performed simulated-use testing under observation for all 4 epinephrine delivery systems. Usability (i.e., the ability to perform the manufacturer's labeled instructions), task completion time, and preferences were assessed and analyzed based on device, age, previous experience, sex, device malfunction, and testing order.
RESULTS: More participants correctly followed all device instructions with INT02 (22 [46%]) than with INT01 (13 [27%]), EpiPen (6 [12%]), or TwinJect (0 [0%]). The difference among devices was significant (P < .01) after adjusting for device malfunctions and age group (the youngest age group [those aged 7-10 years] performed significantly worse than the other 2 groups). Prior experience, sex, and testing order did not significantly affect this measure. The first choice of overall preference was greater (P < .001) for INT02 (35 participants [73%]) vs. INT01 (7 participants [15%]), EpiPen (5 participants [10%]), and TwinJect (1 participant [2%]).
CONCLUSION: The user-centered device design may have a significant impact on correct epinephrine autoinjector use and patient preference.

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Year:  2010        PMID: 20306821      PMCID: PMC2892620          DOI: 10.1016/j.anai.2009.11.023

Source DB:  PubMed          Journal:  Ann Allergy Asthma Immunol        ISSN: 1081-1206            Impact factor:   6.347


  12 in total

1.  Use assessment of self-administered epinephrine among food-allergic children and pediatricians.

Authors:  S H Sicherer; J A Forman; S A Noone
Journal:  Pediatrics       Date:  2000-02       Impact factor: 7.124

Review 2.  First-aid treatment of anaphylaxis to food: focus on epinephrine.

Authors:  F Estelle R Simons
Journal:  J Allergy Clin Immunol       Date:  2004-05       Impact factor: 10.793

3.  Parental use of EpiPen for children with food allergies.

Authors:  Jennifer S Kim; James M Sinacore; Jacqueline A Pongracic
Journal:  J Allergy Clin Immunol       Date:  2005-07       Impact factor: 10.793

4.  EpiPen Jr versus EpiPen in young children weighing 15 to 30 kg at risk for anaphylaxis.

Authors:  F Estelle R Simons; Xiaochen Gu; Norman A Silver; Keith J Simons
Journal:  J Allergy Clin Immunol       Date:  2002-01       Impact factor: 10.793

5.  Anaphylaxis and epinephrine auto-injector training: who will teach the teachers?

Authors:  M Grouhi; M Alshehri; D Hummel; C M Roifman
Journal:  J Allergy Clin Immunol       Date:  1999-07       Impact factor: 10.793

Review 6.  Self-injectable epinephrine for first-aid management of anaphylaxis.

Authors:  Scott H Sicherer; F Estelle R Simons
Journal:  Pediatrics       Date:  2007-03       Impact factor: 7.124

7.  Nuts! I can't figure out how to use my life-saving epinephrine auto-injector!

Authors:  Laura Lin Gosbee
Journal:  Jt Comm J Qual Saf       Date:  2004-04

8.  The etiology and incidence of anaphylaxis in Rochester, Minnesota: a report from the Rochester Epidemiology Project.

Authors:  Wyatt W Decker; Ronna L Campbell; Veena Manivannan; Anuradha Luke; Jennifer L St Sauver; Amy Weaver; M Fernanda Bellolio; Eric J Bergstralh; Latha G Stead; James T C Li
Journal:  J Allergy Clin Immunol       Date:  2008-11-06       Impact factor: 10.793

9.  Human factors in the health care facility.

Authors:  D L Welch
Journal:  Biomed Instrum Technol       Date:  1998 May-Jun

10.  Accidental injection of epinephrine by a child: a unique approach to treatment.

Authors:  C Sellens; L Morrison
Journal:  CJEM       Date:  1999-04       Impact factor: 2.410

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  10 in total

1.  How far from correct is the use of adrenaline auto-injectors? A survey in Italian patients.

Authors:  Erminia Ridolo; Marcello Montagni; Laura Bonzano; Eleonora Savi; Silvia Peveri; Maria Teresa Costantino; Mariangiola Crivellaro; Giuseppina Manzotti; Carlo Lombardi; Marco Caminati; Cristoforo Incorvaia; Gianenrico Senna
Journal:  Intern Emerg Med       Date:  2015-05-20       Impact factor: 3.397

2.  Intelliject's novel epinephrine autoinjector: sharps injury prevention validation and comparable analysis with EpiPen and Twinject.

Authors:  Stephanie Guerlain; Lu Wang; Akilah Hugine
Journal:  Ann Allergy Asthma Immunol       Date:  2010-12       Impact factor: 6.347

Review 3.  Patient Ability to Use Old versus New/Modified Model Adrenaline Autoinjection Emergency Medical Devices for Anaphylaxis in Prehospital Setting: A Systematic Review and Meta-Analysis.

Authors:  Leong Chow Wei; Mohd Boniami Yazid; Mohd Noor Norhayati; Abu Yazid Md Noh; Andey Rahman
Journal:  Healthcare (Basel)       Date:  2022-01-18

4.  Adrenaline in the Acute Treatment of Anaphylaxis.

Authors:  Johannes Ring; Ludger Klimek; Margitta Worm
Journal:  Dtsch Arztebl Int       Date:  2018-08-06       Impact factor: 5.594

5.  [Management of anaphylaxis : part 2: treatment and emergency equipment].

Authors:  L Klimek; U Goebel; A Glowania
Journal:  HNO       Date:  2012-12       Impact factor: 1.284

6.  Usability of a new disposable autoinjector platform device: results of a formative study conducted with a broad user population.

Authors:  Jakob Lange; Philipp Richard; Nick Bradley
Journal:  Med Devices (Auckl)       Date:  2015-06-03

7.  Guideline (S2k) on acute therapy and management of anaphylaxis: 2021 update: S2k-Guideline of the German Society for Allergology and Clinical Immunology (DGAKI), the Medical Association of German Allergologists (AeDA), the Society of Pediatric Allergology and Environmental Medicine (GPA), the German Academy of Allergology and Environmental Medicine (DAAU), the German Professional Association of Pediatricians (BVKJ), the Society for Neonatology and Pediatric Intensive Care (GNPI), the German Society of Dermatology (DDG), the Austrian Society for Allergology and Immunology (ÖGAI), the Swiss Society for Allergy and Immunology (SGAI), the German Society of Anaesthesiology and Intensive Care Medicine (DGAI), the German Society of Pharmacology (DGP), the German Respiratory Society (DGP), the patient organization German Allergy and Asthma Association (DAAB), the German Working Group of Anaphylaxis Training and Education (AGATE).

Authors:  Johannes Ring; Kirsten Beyer; Tilo Biedermann; Andreas Bircher; Matthias Fischer; Thomas Fuchs; Axel Heller; Florian Hoffmann; Isidor Huttegger; Thilo Jakob; Ludger Klimek; Matthias V Kopp; Claudia Kugler; Lars Lange; Oliver Pfaar; Ernst Rietschel; Franziska Rueff; Sabine Schnadt; Roland Seifert; Britta Stöcker; Regina Treudler; Christian Vogelberg; Thomas Werfel; Margitta Worm; Helmut Sitter; Knut Brockow
Journal:  Allergo J Int       Date:  2021-01-28

Review 8.  Adrenaline auto-injectors for the treatment of anaphylaxis with and without cardiovascular collapse in the community.

Authors:  Aziz Sheikh; F Estelle R Simons; Victoria Barbour; Allison Worth
Journal:  Cochrane Database Syst Rev       Date:  2012-08-15

9.  The science of human factors: separating fact from fiction.

Authors:  Alissa L Russ; Rollin J Fairbanks; Ben-Tzion Karsh; Laura G Militello; Jason J Saleem; Robert L Wears
Journal:  BMJ Qual Saf       Date:  2013-04-16       Impact factor: 7.035

Review 10. 

Authors:  Johannes Ring; Kirsten Beyer; Tilo Biedermann; Andreas Bircher; Matthias Fischer; Axel Heller; Isidor Huttegger; Thilo Jakob; Ludger Klimek; Matthias V Kopp; Claudia Kugler; Lars Lange; Oliver Pfaar; Ernst Rietschel; Franziska Rueff; Sabine Schnadt; Roland Seifert; Britta Stöcker; Regina Treudler; Christian Vogelberg; Thomas Werfel; Margitta Worm; Helmut Sitter; Knut Brockow
Journal:  Allergo J       Date:  2021-02-12
  10 in total

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