Journal of paediatrics and child health | 2021
Time trends in adrenaline auto-injector dispensing patterns using Australian Pharmaceutical Benefits Scheme data.
Abstract
AIM\nAdrenaline auto-injector (AAI) dispensing data, a community-based proxy for number of individuals at risk of anaphylaxis, provides complementary information on time trends of anaphylaxis risk in addition to hospital admission data. We examined trends of AAI dispensing over a 10-year period (from January 2005 to December 2014) in Australia.\n\n\nMETHODS\nIndividuals with dispensed AAI were identified from a 10% random sample of Australian Pharmaceutical Benefits Scheme (PBS) data. PBS is the Australian national drug subsidy programme covering all Australians. Cumulative incidence and incidence rates of individuals with AAI were calculated. We assessed difference by age, sex, state and time trends.\n\n\nRESULTS\nThe cumulative incidence of individuals with AAI in 2005-2014 was 75.43/100\u2009000 (95%CI 75.07-75.80/100\u2009000). Incidence rate of individuals with AAI increased from 2005 to 2014 (from 71.47 to 82.07 per 100\u2009000 person-years) although this varied by state. Over the time assessed, there was a shift to more prescriptions being provided by general practitioners (GP) rather than specialists. Children (0-19\u2009years) were more likely to have been prescribed an AAI from a specialist and adults from a GP.\n\n\nCONCLUSION\nOverall, an increase in dispensed AAI mirrored other evidence for a rising prevalence of allergy. This increase could also reflect changes in prescribing practices or increased awareness and education of health-care professionals on anaphylaxis and indications for prescribing AAI. The rising rate of AAI prescribed by GPs compared to decreasing rates by specialists suggests a changing response of the Australian health-care system to the increased burden of anaphylaxis.