Many pediatricians and allergists failed to provide instructions for when and how to use epinephrine and a written emergency action plan to the parents of children with food allergies, a study found.

Researchers asked the parents of 859 children with allergies to share their level of satisfaction with the care and delivery of care from the pediatricians and allergists treating their children over the course of the previous 6 months. While more than 75% of the doctors treated the parents courteously and respectfully and provided clear explanations of children’s allergies, a high percentage of the doctors neglected to provide other information essential for caring for children with food allergies, the parents reported.

The parents most often said they were missing explanations on when and how their children should be receiving epinephrine to treat allergic reactions and instructions on exactly what to do if their children had a medical emergency related to their specific allergies and circumstances. More pediatricians than allergists failed to share such information.

Among allergists, 68% explained when to use epinephrine, while 37% of pediatricians provided such information, the parents reported. Instructions on how to use epinephrine were provided to parents by 47% of allergists and 20% of pediatricians. Written emergency health care plans customized to each child were provided by 56% of the allergists and 24% of the pediatricians

“Although pediatricians might be relying on allergists to deliver [an emergency action plan and training in epinephrine autoinjectors use], with the rise in food allergies, guidelines recommend that pediatricians conduct these steps and not rely solely on the allergist,” said Jesse A. Blumenstock of Northwestern University, Chicago, and colleagues. “With our understanding of food allergy and anaphylaxis constantly evolving, guidelines and recommendations for how and when to give epinephrine and the need for an action plan need to be reinforced by physicians.”

Read the study in the Journal of Allergy and Clinical Immunology: In Practice ( doi: 10.1016/j.jaip.2015.10.011 ).