Patients at risk for anaphylaxis, and the caregivers of children facing the same threat, overwhelmingly prefer needle-free epinephrine delivery methods, according to research presented this week at the American Academy of Allergy, Asthma & Immunology (AAAAI) Annual Meeting in Philadelphia.
The study, conducted by the Allergy & Asthma Network, surveyed 210 individuals – patients at risk of anaphylaxis and those responsible for children with the condition – between July 9 and July 12, 2025. Results indicated that 90% of respondents expressed a preference for needle-free epinephrine administration over traditional autoinjectors.
Researchers, led by De De Gardner, DrPH, RRT, RRT-NPS, FAARC, FCCP, chief research officer at Allergy & Asthma Network, found that concerns about needle aversion and the physical size of autoinjectors were significant factors driving this preference. 89% of those surveyed indicated a preference for epinephrine delivery devices that were smaller and easier to carry.
“Patients and caregivers of children who are at risk for experiencing anaphylaxis indicated a strong preference for needle-free, highly portable epinephrine forms,” Gardner said. “Clinicians can leverage these findings to support patients’ preferences for needle-free administration options for epinephrine.”
The survey also revealed concerns regarding environmental factors affecting epinephrine efficacy. 87% of respondents expressed concern about the potential impact of heat on their epinephrine, while 70% worried about the effects of cold. Priorities when choosing a delivery method included ease of use (77%), portability (71%), and clinician recommendation (61%). Device size (47%), temperature stability (42%), and the presence of a needle (33%) were also considered.
Respondents anticipated a faster response time with needle-free options, estimating epinephrine administration within 7 minutes compared to 10 minutes with an autoinjector. Gardner emphasized the importance of prompt epinephrine use, stating, “We teach patients and caregivers, ‘If you think you need it, use it. Don’t wait.’”
The findings come as alternative epinephrine delivery methods, including nasal sprays and epinephrine films, are emerging. While the traditional route of administration remains injection, the study highlights a clear demand for less invasive options that may encourage quicker action among those hesitant to use autoinjectors due to needle phobia or concerns about administering them to children.
The Allergy & Asthma Network’s research suggests a potential shift in patient and caregiver preferences, which clinicians may want to consider when discussing epinephrine auto-injection options.
