Follow up care of patients in southwest Germany with a history of Hymenoptera venom anaphylaxis

Abstract: Up to 3.5% of the population experience anaphylactic reactions in response to Hymenoptera stings. Current guidelines are in place for the diagnostic work up and long term therapy of patients with Hymenoptera venom anaphylaxis (HVA); however little is known about the degree of implementation of the recommendations and patient attitudes toward them. To address this issue a retrospective questionnaire-based study was conducted with patients that had received treatment from an emergency medical response team for HVA, as documented in records of three regional Medical Emergency Response Centers in southwest Germany. The questionnaire contained 45 questions and addressed reaction characteristics, acute treatment, follow up visits, emergency medications, diagnostics, and venom immunotherapy (VIT).
From over 125,000 emergency cases a filtered list of 1,895 patients that coded for anaphylaxis was generated and examination of paper records identified 548 patients with a documented insect sting anaphylaxis. Patients were sent a standardized questionnaire addressing different aspects of diagnostics and follow up care. The response rate was 27% and a total of 126 patients were included in the analysis.
Ninety percent of the patients received a prescription for emergency medication, 77% including an adrenalin auto injector, of which 50% were expired at the time of the survey. Forty-three percent of patients rarely or never carried their emergency medications. Almost forty percent of patients prescribed emergency medicine felt that carrying them was annoying and troublesome. Over 50% did not consult an allergy specialist at any time after the index sting, and almost 40 % did not receive a referral to an allergist at the emergency center. About one quarter did not receive any form of diagnostic work up, over 30% did not receive any information about VIT as treatment option and only 50% were started on VIT. The reason most often given for not undergoing VIT was that patients had only had one reaction, followed by reasons involving the effort/time investment necessary. We also found that follow up care was independent of insurance, gender, and region. Unsurprisingly patients who sought treatment at specialized centers were more likely to receive follow up care.
Our results indicate that there are missed opportunities for secondary and tertiary prevention of anaphylaxis due to insect venom allergy

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch
• Notes: cc_by_nc_nd http://creativecommons.org/licenses/by-nc-nd/4.0/deed.de cc ; Albert-Ludwigs-Universität Freiburg, Dissertation, 2017

Classification and Topics

• Keyword: Anaphylaxie ; Allergie ; Immunkrankheit

Contributors, Places and Time

• Event: Veröffentlichung
• (where): Freiburg
• (who): Universität
• (when): 2017
• Creator: Manmohan, Manisha
• Contributor: Jakob, Thilo ; Albert-Ludwigs-Universität Freiburg. Medizinische Fakultät ; Albert-Ludwigs-Universität Freiburg

Further information

• DOI: 10.6094/UNIFR/13822
• URN: urn:nbn:de:bsz:25-freidok-138225
• Rights: Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 25.03.2025, 1:53 PM CET