From Fear to Preparedness: A Systematic Review of Parents' Awareness and Use of Epinephrine Autoinjectors

This systematic review aims to synthesize existing literature on parents' knowledge and use of epinephrine autoinjectors (EAIs) and identify factors associated with correct use and barriers to education and training. A comprehensive search was conducted on PubMed and the Directory of Open Access Journals (DOAJ) using keywords and MeSH terms. Inclusion and exclusion criteria were established, and papers were screened for eligibility. Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal tool. A total of 1008 papers were initially identified, with 214 remaining after applying filters. Following screening and quality assessment, seven observational studies were included in the review. The studies found that while most caregivers claimed to carry an EAI on their person and practiced its use at home after training, it was often not used during allergic reactions. The most common reason cited for not using EAI was uncertainty about whether the symptoms were severe enough to warrant EAI use. The lack of EAI use was significantly associated with lower caregiver confidence in using EAI. Those who received EAI during oral food challenges (OFC) and in the community had increased confidence in administering the EAI from pre-OFC to follow-up compared to those who did not receive EAI at all. Targeted interventions and educational strategies should be developed to improve parent knowledge and use of EAIs.