| Content Provider |
World Health Organization (WHO)-Global Index Medicus |
| Author |
Desjardins, Marylin Clarke, Ann Alizadehfar, Reza Grenier, Danielle Eisman, Harley Carr, Stuart Vander Leek, Timothy K. Teperman, Lee Higgins, Niamh Joseph, Lawrence Shand, Greg Ben-Shoshan, Moshe |
| Spatial Coverage |
Canada |
| Description |
Author Affiliation: Desjardins M ( Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada. Electronic address: marylin.desjardins@mail.mcgill.ca.); Clarke A ( Division of Allergy and Clinical Immunology, Department of Medicine, McGill University Health Center, Montreal, Quebec, Canada); Alizadehfar R ( Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada.); Grenier D ( Department of Pediatrics, University of Ottawa, Canadian Paediatric Society, Ottawa, Ontario, Canada.); Eisman H ( Montreal Children's Hospital, Emergency Department, McGill University Health Center, Montreal, Quebec, Canada.); Carr S ( Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, University of Alberta, Alberta, Canada.); Vander Leek TK ( Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, University of Alberta, Alberta, Canada.); Teperman L ( Society of Rural Physicians of Canada, Shawville, Quebec, Canada.); Higgins N ( Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.); Joseph L ( Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.); Shand G ( Department of Epidemiology, McGill University Health Center, Montreal, Quebec, Canada.); Ben-Shoshan M ( Division of Pediatric Allergy and Clinical Immunology, Department of Pediatrics, McGill University Health Center, Montreal, Quebec, Canada.) |
| Abstract |
BACKGROUND: Studies suggest knowledge gaps about epinephrine use and vaccination of persons with egg allergy. OBJECTIVE: We compared the perception of Canadian allergists and nonallergists on issues related to epinephrine use and vaccination of persons with egg allergy. METHODS: Canadian allergists, pediatricians, general practitioners/family physicians and emergency room physicians were recruited through medical associations and surveyed on these issues. Multivariate logistic regression models were used to identify determinants of specific responses. RESULTS: One-hundred fourteen allergists and 613 nonallergists participated. For most issues with accepted best practices, allergists were more likely to adhere to recommendations. Allergists versus nonallergists were more likely to recommend intramuscular epinephrine for anaphylaxis (odds ratio [OR] = 3.8; 95% CI, 1.43-10.11). Older physicians (OR = 0.98; 95% CI, 0.97-0.99), Canadian-Paediatric-Surveillance-Program participants (OR = 0.48; 95% CI, 0.24-0.96), family physicians (OR = 0.39; 95% CI, 0.16-0.96), and general practitioners (OR = 0.14; 95% CI, 0.04-0.52) were less likely to recommend intramuscular use. However, in severe anaphylaxis, >25% of both groups would not give epinephrine for patients presenting with breathing difficulties or hypotension. Use of epinephrine for severe anaphylaxis was less likely in older physicians (OR = 0.97; 95% CI, 0.95-0.99), female physicians (OR = 0.60; 95% CI, 0.39-0.89), and those practicing in Ontario (OR = 0.56; 95% CI, 0.36-0.86), Manitoba (OR = 0.42; 95% CI, 0.19-0.90), or Nova-Scotia (OR = 0.31; 95% CI, 0.12-0.78). Allergists (OR = 6.22; 95% CI, 3.60-10.72) and physicians treating mainly children (OR = 3.41; 95% CI, 1.87-6.25), or practicing in Quebec (OR = 1.68; 95% CI, 1.12-2.55) were more likely to recommend measles-mumps-rubella vaccination in a community facility. CONCLUSION: Knowledge gaps about mode and indications for epinephrine administration and vaccination policies need to be addressed in future education programs to ensure prompt epinephrine use and to avoid unnecessary restriction of vaccines. |
| File Format |
HTM / HTML |
| ISSN |
22132198 |
| e-ISSN |
22132201 |
| Journal |
The Journal of Allergy and Clinical Immunology: In Practice |
| Issue Number |
3 |
| Volume Number |
1 |
| Language |
English |
| Publisher |
Elsevier |
| Publisher Date |
2013-05-01 |
| Publisher Place |
United States |
| Access Restriction |
Open |
| Subject Keyword |
Discipline Immunology Allergy And Immunology Egg Hypersensitivity Immunology Prevention & Control Epinephrine Administration & Dosage Specialization Vaccination Anaphylaxis Diagnosis Drug Therapy Etiology Canada Desensitization, Immunologic Therapeutic Use Practice Guidelines As Topic Self Medication Questionnaires Comparative Study Research Support, Non-u.s. Gov't |
| Content Type |
Text |
| Resource Type |
Article |
| Subject |
Immunology and Allergy |
