Epinephrine Autoinjector Prescription Filling after Pediatric Emergency
Department Discharge
Abstract
Background: There are known racial and socioeconomic disparities in the
use of epinephrine autoinjectors for anaphylaxis. Objective: To measure
rates of epinephrine autoinjector prescription filling and identify
patient demographic factors associated with filling rates among patients
discharged from the pediatric emergency department Methods: This was a
retrospective observational cohort study of all patients discharged from
a pediatric emergency department who received an outpatient prescription
for an epinephrine autoinjector between January 1, 2018 and October 31,
2019. Rates of prescription filling were calculated, and multivariable
logistic regression was performed to identify sociodemographic factors
associated with prescription filling. Results: Of 717 patients included
in the analysis, 54.8% (95% CI 51.1,58.5) filled their prescription.
There were no significant associations between EAI fill rates and
patient age or sex. In bivariable analysis, Non-Hispanic white patients
were more likely to fill EAI prescriptions compared to Non-Hispanic
black patients (OR 1.89, 95% CI 1.11, 3.20) and patients with in-state
Medicaid were significantly less likely to fill EAI prescriptions
compared to those patients with private insurance (OR 0.69, 95% CI
0.48, 0.98). However, after multivariable adjustment there was no
significant difference in filling by age, insurance status or
race/ethnicity. Conclusions: Only approximately half the patients filled
their EAI prescriptions after discharge. Filling rates do not vary by
sociodemographic characteristics.