ArticleClinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology2026
Adrenaline Auto-Injector Prescribing in Primary Care in England: An Analysis of Non-Standard Dosing.
Article in Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe recommended first-line treatment for anaphylaxis in the community is intramuscular injection of adrenaline. The treatment is a standardised dose of either a 150 μg or a 300 μg adrenaline auto-injector (AAI) device depending upon the patient's weight. Currently, no standardised mechanisms exist to transition patients onto the higher 300 μg dose when they reach 25-30 kg (depending upon the manufacturer).
methodsWe undertook analysis of NHS prescriptions data dispensed in the community in England to identify rates of non-standard AAI dose prescribing. Non-standard prescribing is defined as patients who are likely to have exceeded the 25-30 kg threshold but still received a 150 μg dose. Data were limited to the most recent AAI prescription for an individual patient that occurred in the last 2 years (December 2022-2024). Patient weight at the time of prescribing was approximated using an age-to-weight correlation model. AAI recommended switching weights, based on device metadata, were compared to the patients' approximated weight to identify non-standard prescribing. Statistical comparison between rates of non-standard prescribing and patient deprivation was computed using Kendall's Tau correlation coefficient. A complementary analysis to identify patients who received a 300 μg dose but were likely under the 25-30 kg threshold was also carried out.
resultsOverall, 46,999 patients were identified as having received a 150 μg strength injector in their most recent AAI prescription; of these, over 95% received two or more devices in line with national guidance. Estimates based on age for weight growth centiles show that between 9480 (20.2%) and at least 1747 (3.7%) of those prescribed a 150 μg autoinjector were likely to exceed the weight threshold for this dose. Using a Resuscitation Council UK guideline of age 6 years for switching to a 300 μg dose, the estimated proportion prescribed a non-standard AAI dose increases to 23,059 patients (49.1%). Estimated rates of non-standard AAI prescribing were found to be higher in areas of England with the most deprivation. Conservative estimates found only 67 children likely under 25 kg and 330 children likely under 30 kg who received a 300 μg dose.
conclusionsThis analysis of community AAI prescriptions in England suggests that underdosing of AAI prescriptions in children and adults is not uncommon. Healthcare professionals with patients at risk of anaphylaxis should review whether patients prescribed AAI devices have the appropriate device for their weight.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.