Evidence map›Paper›PMID 25009138›Full record

Trial reportBMJ open2014

Pharmacists' response to anaphylaxis in the community (PRAC): a randomised, simulated patient study of pharmacist practice.

Sandra M Salter, Brock Delfante, Sarah de Klerk, Frank M Sanfilippo, Rhonda M Clifford

Open access · goldAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
0.9field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 16 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Demonstration of epinephrine autoinjectors (EpiPen and Anapen) by pharmacists in a randomised, simulated patient assessment: acceptable, but room for improvement.Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology · 2014
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 1 institution in 1 country.

Sandra M SalterPharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia.
Brock DelfantePharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia.
Sarah de KlerkPharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia.
Frank M SanfilippoSchool of Population Health, The University of Western Australia, Crawley, Western Australia, Australia.
Rhonda M CliffordPharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia.
University of Western Australia · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo evaluate how community pharmacists manage patients with anaphylaxis.

designA randomised, cross-sectional, simulated patient study of community pharmacist practice.

setting300 metropolitan pharmacies located in Perth Australia, randomised to three groups of 100 pharmacies. Each group corresponded to a different epinephrine autoinjector: original EpiPen, new-look EpiPen or Anapen.

participants300 pharmacies were visited with 271 simulated patient visits included in the final analysis (88=original EpiPen, 92=new-look EpiPen, 91=Anapen). OUTCOME MEASURES: Primary anaphylaxis preparedness (readiness to treat acute anaphylaxis). Secondary anaphylaxis engagement (willingness to engage the patient in a discussion about their anaphylaxis).

methodsSimulated patients approached pharmacists, using a standardised scenario, for assistance with epinephrine autoinjector use and advice about the use of antihistamines in anaphylaxis. Scores for each outcome were obtained based on the number of predefined statements addressed by the pharmacist during the consultation (maximum score=5 for preparedness and 8 for engagement).

resultsThe mean anaphylaxis preparedness score was 2.39 points (SD 1.17). Scores for new-look EpiPen were significantly higher than for original EpiPen and Anapen (2.75 vs 2.38 points, p=0.027; 2.75 vs 2.03 points, p<0.001, respectively). Overall, 17.3% of pharmacists correctly demonstrated the epinephrine autoinjector. The mean anaphylaxis engagement score was 3.11 points (SD 1.73). Scores for new-look EpiPen were similar to original EpiPen and Anapen (3.11 vs 3.32 points; 3.11 vs 2.90 points, both p=0.42). Engagement was associated with preparedness. For each additional engagement point, preparedness increased by 7% (0.357 points; 95% CI 0.291 to 0.424; p<0.001).

conclusionsPharmacists demonstrated reasonable knowledge of anaphylaxis symptoms and emergency care, but had poor epinephrine autoinjector technique and rarely discussed anaphylaxis action plans. Pharmacists who had a more comprehensive discussion about anaphylaxis with patients, were more prepared for anaphylaxis emergencies. Future research should evaluate the nature and significance of errors in pharmacists' autoinjector technique.

Indexed as

Community Pharmacy ServicesPatient SimulationAdultAnaphylaxisCross-Sectional StudiesEpinephrineFemaleHumansMaleMiddle AgedYoung AdultEpinephrineAnaphylaxisPharmacy PracticePrimary CAreSimulated Patient

Identifiers

PMID25009138
PMCPMC4091503
OpenAlexW2107978530

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.