A Patient Education Intervention to Address Allergic Anaphylaxis-Related Quality-of-Life and Self-Efficacy

Caroline Belin,1,2 Cecília Tomori1,2 1Johns Hopkins School of Nursing, Baltimore, MD, USA; 2Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USACorrespondence: Cecília Tomori, Johns Hopkins School of Nursing, 525 N Wolfe St, Baltimore, MD, 21205, USA, Email [email protected]: Allergic anaphylaxis diagnoses can impact quality of life and self-efficacy, which in turn can lead to poor outcomes. Patient education can help empower patients but may be inadequately implemented in clinical settings.Methods: This quality improvement study utilized a retrospective pretest-posttest brief educational intervention design and retrospective chart review over 12 weeks in an allergy specialty practice. Adult-Anaphylaxis-QoL (A-QoL) and New General Self-Efficacy (NGSE) scales were analyzed with SPSS using Wilcoxon Sign Rank tests.Results: Sixty-six patients received the intervention. A-QoL was slightly, but statistically significantly, higher overall post intervention, 3.88 pre-test median, (IQR = 2.85, 4.81) vs post-intervention 3.95 median (IQR = 3.38, 4.68), (Z = − 2.77, p < 0.01, d = − 0.73). Significant improvements in social, emotional, and limitation subscales were found (p< 0.01), with the largest improvement in the emotional subscale. A small, statistically significant, increase was also found in self-efficacy, 3.94 pretest median (IQR 3.25, 4.28), vs 4.13 post-test median (IQR 4.12, 4.75, p < 0.01), (Z = − 4.43, p < 0.01, d = − 1.30).Discussion: The implementation of evidence-based prevention-focused patient education was associated with modest but statistically significant increases in anaphylaxis-related quality of life and small, significant improvements in self-efficacy. This intervention was successfully implemented in a specialty allergy clinic to improve these outcomes and can be part of broader efforts to enhance patient education to reduce delays and improve appropriate use of epinephrine auto-injector.Conclusion: Brief, evidence-based patient education can modestly improve quality of life and self-efficacy for severely allergic patients. More comprehensive interventions in diverse settings are needed to ensure that patient-centered education is coupled with linkage to epinephrine auto-injector carriage to ensure improved anaphylaxis outcomes.Plain Language Summary: Why was the study done?Many people have severe allergic reactions. These can be prevented with immediate first aid use of medication, but often there are delays. We know that there are many reasons for this delay, including how people feel about their illness, along with other factors. This study was done to see if patient education based on best available evidence can help make a positive difference for how people at risk for severe allergic reactions feel about their illness, which may help reduce these delays in the future.What did the researchers do and find?We developed and implemented a patient education intervention over the course of 12 weeks in an allergy clinic. The patient education was based on best practices in the field. We found that patient education made a small but important difference for patients’ quality of life, especially for their emotional health. The intervention also made a small difference for their confidence.What do these results mean?Patient education is an important part of improving care for people who have severe allergic reactions. We need high-quality patient education to be part of larger changes in clinical care so that all patients can have information about how to prevent severe allergic reactions and that they can access necessary medication to do so.Keywords: anaphylaxis, allergy, epinephrine, patient education, quality of life, self-efficacy, health equity