TY - JOUR
T1 - Under Prescription of Epinephrine to Medicaid Patients in the Pediatric Emergency Department
AU - Owusu-Ansah, Sylvia
AU - Badaki, Oluwakemi
AU - Perin, Jamie
AU - Stevens, Martha
AU - Anders, Jennifer
AU - Wood, Robert
N1 - Funding Information:
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This study was supported by Food Allergy Research and Education (FARE), # 90059409.
Publisher Copyright:
© The Author(s) 2019.
PY - 2019
Y1 - 2019
N2 - Objective. To describe pediatric Medicaid patients with pediatric emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those who did not; and to compare patients who filled their prescriptions versus those who did not. Methods. We conducted a cross-sectional study of Medicaid patients aged 0 to 21 years presenting to 2 PEDs, with symptoms meeting the National Institute of Allergy and Infectious Diseases criteria for anaphylaxis, between July 2012 and July 2014. Results. We identified 86 patients across the 2 hospitals with a confirmed diagnosis of anaphylaxis in the PED. Of these, 55 (64%, 95% confidence interval [CI] = 53% to 74%) received a prescription for an EAI during their ED visit. Forty-two (68%; 95% CI = 56% to 80%) received a prescription for EAI in Hospital 1 versus 13 (54%; 95% CI = 33% to 74%) in Hospital 2. Medicaid prescription fill rates were available for Hospital 1. Of the 42 who received an EAI prescription, 36 (86%; 95% CI = 75% to 96%) filled these prescriptions with Medicaid. Of the 20 (32%) out of 62 patients with anaphylaxis who did not receive prescriptions for an EAI, only 5 had previously filled prescriptions for epinephrine. Conclusion. Previous Medicaid patient prescription adherence data suggested that these patients would have a low EAI prescription fill rate. We found Medicaid patients who received prescriptions for an EAI after the ED visit for anaphylaxis filled them; however, a considerable proportion of anaphylaxis visits had no EAI prescription provided at discharge.
AB - Objective. To describe pediatric Medicaid patients with pediatric emergency department (PED) visits for anaphylaxis who received epinephrine auto-injector (EAI) prescriptions in the ED versus those who did not; and to compare patients who filled their prescriptions versus those who did not. Methods. We conducted a cross-sectional study of Medicaid patients aged 0 to 21 years presenting to 2 PEDs, with symptoms meeting the National Institute of Allergy and Infectious Diseases criteria for anaphylaxis, between July 2012 and July 2014. Results. We identified 86 patients across the 2 hospitals with a confirmed diagnosis of anaphylaxis in the PED. Of these, 55 (64%, 95% confidence interval [CI] = 53% to 74%) received a prescription for an EAI during their ED visit. Forty-two (68%; 95% CI = 56% to 80%) received a prescription for EAI in Hospital 1 versus 13 (54%; 95% CI = 33% to 74%) in Hospital 2. Medicaid prescription fill rates were available for Hospital 1. Of the 42 who received an EAI prescription, 36 (86%; 95% CI = 75% to 96%) filled these prescriptions with Medicaid. Of the 20 (32%) out of 62 patients with anaphylaxis who did not receive prescriptions for an EAI, only 5 had previously filled prescriptions for epinephrine. Conclusion. Previous Medicaid patient prescription adherence data suggested that these patients would have a low EAI prescription fill rate. We found Medicaid patients who received prescriptions for an EAI after the ED visit for anaphylaxis filled them; however, a considerable proportion of anaphylaxis visits had no EAI prescription provided at discharge.
KW - electronic medical record
KW - emergency department
KW - epinephrine auto injector
KW - food allergy and anaphylaxis network
KW - international classification of diseases-9
KW - national institute of allergy and infectious disease
KW - pediatric emergency department
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U2 - 10.1177/2333794X19854960
DO - 10.1177/2333794X19854960
M3 - Article
C2 - 31236431
AN - SCOPUS:85085655354
SN - 2333-794X
VL - 6
JO - Global Pediatric Health
JF - Global Pediatric Health
ER -