Hogue S, Hollis K, Silvia S, Wooddell M. The EpiPen4Schools® survey: staff training and use of epinephrine auto-injectors for the treatment of anaphylaxis in large US school districts. Poster presented at the 2015 ISPOR 18th Annual European Congress; November 2015. [abstract] Value in Health Regional Issues. 2015 Nov; 18(7):A505. doi: 10.1016/j.jval.2015.09.1441

OBJECTIVES: The EPIPEN4SCHOOLS® program (Mylan Specialty L.P., Canonsburg, PA) provides epinephrine auto-injectors (EAIs) to qualifying schools in the United States. A pilot web-based survey of participating schools described anaphylactic events reported during the 2013-2014 school year.1This pilot survey was extended to large school districts (>50 schools per district) to better understand preparedness for anaphylaxis in such settings.

METHODS: This cross-sectional, web-based pilot survey analyzed anaphylactic events in large districts participating in the EpiPen4Schools program.

RESULTS: Among 808 responding schools (representing 47 districts), 286 anaphylactic events were reported. Of the 265 anaphylactic events with data on EAI use, 77.4% (n=205) were treated by EAI. A stock EAI from the EpiPen4Schools program was used to treat 60.0% of individuals (96/160) experiencing an event. Of the 702 schools with information on staff training on anaphylaxis, 47.7% (335/702) provided training for the school nurse and select staff; 20.1% (141/702) and 29.2% (205/702) provided training for most staff and all staff, respectively. Most schools (62.3%, 437/702) permitted the school nurse and select staff to administer EAIs to treat anaphylaxis; 12.8% (90/702) and 18.9% (133/702) permitted most or all staff, respectively, to administer EAIs.

CONCLUSIONS: Sixty percent of individuals experiencing anaphylaxis were treated with EAIs from the EpiPen4Schools program, emphasizing the value of stocking EAIs. Notably, most schools permitted only the school nurse and select staff to treat anaphylactic reactions. Thus, students may routinely encounter staff members who cannot provide appropriate care during a life-threatening reaction. Because of the increased healthcare costs and risk of poor outcomes associated with delaying treatment of anaphylactic reactions with epinephrine, there is a continued public health need to remove barriers to EAI access and proper training in schools to recognize and manage anaphylaxis.

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