Investigating the management of anaphylaxis in pharmacy: a growing need for pharmacist-driven community competence in the preparedness and care of people at risk of anaphylaxis

    Research output: ThesisDoctoral Thesis

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    Abstract

    [Truncated] Anaphylaxis is a severe allergic reaction that is rapid in onset and can cause death. Recent and dramatic increases in prevalence have been driven by new and persisting allergies to food, insect venoms and medicines. Anaphylaxis in the community is a real concern because access to a health professional may be delayed, and death can occur within minutes.
    Management of anaphylaxis in the community requires acute and long-term care. Acute treatment relies on the recognition of anaphylaxis and early use of adrenaline autoinjectors. Long-term care focuses on identification and avoidance of allergens, and preparation for recurrences. Education is crucial for both. Notwithstanding their role in supplying medicines, pharmacists can make a significant contribution to the education and care of anaphylaxis patients. In acute care, pharmacists should be ready to manage(and treat if necessary), patients who approach them suffering acute anaphylaxis. For long-term care, pharmacists prepare the patient to self-manage their anaphylaxis, through provision of advice and adrenaline autoinjectors.
    This thesis investigates pharmacists’ preparedness for managing anaphylaxis, with a focus on education, knowledge and the interaction between pharmacists and people at risk of anaphylaxis. Four research areas are identified:
    1. A systematic review of the literature was undertaken to investigate whether elearning would be an effective strategy to deliver a standardised anaphylaxis education program to Australian pharmacists.
    2. A controlled intervention study was conducted to determine the effectiveness of a standardised anaphylaxis education program for pharmacists. This education program was delivered online and as face-to-face lectures by the Australasian Society of Clinical Immunology and Allergy (ASCIA). Effectiveness (as knowledge change) was examined in tests on four occasions over 7 months, and compared with a group who did not receive training.
    3. A randomised, simulated patient study was conducted to evaluate how prepared Australian community pharmacists are for anaphylaxis. Willingness to discuss anaphylaxis with the patient was also investigated.
    4. The randomised, simulated patient study further assessed the intricacies of pharmacist accuracy in adrenaline autoinjector demonstration, and compared accuracy between the three different autoinjectors available at the time.
    Original languageEnglish
    QualificationDoctor of Philosophy
    Publication statusUnpublished - 2015

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