Barriers and challenges affecting parents’ use of adrenaline auto-injector in children with anaphylaxis

Table 1 Characteristics of the 47 participating families

Informant
	Father	16 (34)
	Mother	31 (66)
Child’s nationality
	Emirati	39 (83)
	Foreign	8 (17)
Child’s age group
	< 5 yr	21 (45)
	5-10 yr	20 (42)
	> 10 yr	6 (13)
Child’s sex
	Male	25 (53)
	Female	22 (47)
Indication for AAI
	Food allergy	42 (89)
	Idiopathic anaphylaxis	2 (4)
	Insect/venom-induced allergy	3 (7)
Number of AAI prescribed
	1	10 (21)
	2	33 (70)
	3	3 (7)
	4	1 (2)
Parents’ awareness of when to use the AAI
	Rash with breathing difficulty	37 (79)
	Rash with swollen lips	9 (19)
	Unsure	1 (2)
Training provided by
	Doctor	44 (94)
	Nurse	1 (2)
	Pharmacist	1 (2)
	Do not remember	1 (2)
Has used an AAI before		17 (36)

Results expressed as number (percentage). AAI: Adrenaline auto-injector.

Table 2 Frequency of food allergens causing anaphylaxis as reported by parents

Allergen	n	%
Tree nuts	29	62
Peanuts	18	38.5
Egg	9	19
Cow’s milk	8	17
Sesame	7	15
Shrimp	4	8.5
Strawberry	4	8.5
Wheat	3	6.5
Lentil	3	6.5
Others	11	23

Table 3 Univariate analysis of parents and children’s characteristics in association with their reported outcome of training on a Likert scale

		Satisfaction with the training received	Competency in using the AAI	Comfortable and not scared to use the AAI
Child’s gender	Male	3.3 ± 1.0	3.5 ± 0.6	3.5 ± 0.7
	Female	3.2 ± 1.1	3.7 ± 0.8	3.3 ± 0.9
	P value1	0.7	0.2	0.5
Age group (yr)	< 5	3.3 ± 1.1	3.6 ± 0.7	3.5 ± 0.8
	5-10	3.3 ± 1.0	3.7 ± 0.8	3.4 ± 0.8
	> 10	2.8 ± 1.1	3.6 ± 0.8	3.1 ± 0.9
	P value2	0.6	0.8	0.7
Diagnosis	Food allergy	3.2 ± 1.1	3.6 ± 0.7	3.4 ± 0.8
	Idiopathic anaphylaxis	2.5 ± 0.7	3.0 ± 0	2.5 ± 0.7
	Insect/venom induced allergy	3.6 ± 0.6	3.6 ± 0.6	3.3 ± 0.6
	P value2	0.5	0.4	0.2

¹Student unpaired t-test.

²Analysis of variance (ANOVA). AAI: Adrenaline auto-injector.

Table 4 Association between parents’ reported outcome of training and baseline characteristics in an ordered logistic regression model

	Satisfaction with the training received	Competence in using the AAI	Comfortable and not scared to use the AAI
Informant	0.7 (-5.6,2.1); 0.2	-0.9 (-2.2, 0.4); 0.2	-0.4 (-1.7, 0.8); 0.4
Nationality	-0.5 (-2.1, 1.0); 0.5	0.5 (-1.1, 2.1); 0.5	-0.1 (-1.6, 1.3); 0.8
Age group	-0.5 (-1.4, 0.4), 0.3	0.1 (-0.8, 1.1); 0.7	-0.3 (-1.2, 0.6); 0.5
Gender	-0.2 ((-1.4, 1.0); 0.7	-0.2 (-1.4, 1.0); 0.7	0.7 (-0.4, 1.9); 0.2
Diagnosis	0.2 (-0.9, 1.4); 0.6	-0.4 (-1.5, 0.8); 0.5	-0.4 (-1.6, 0.7); 0.5
Training provider	0.4 (-2.2, 3.0); 0.7	-16.4 (-4320, 4287); 0.9	-1.2 (-4.0, 1.5); 0.3
Has used AAI before	0.3 (-0.9, 1.6); 0.6	1.6 (0.2, 2.9); 0.02	0.1 (-1.1, 1.4); 0.8

AAI: Adrenaline auto-injector.