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Trial registered on ANZCTR
Registration number
ACTRN12614001017617
Ethics application status
Approved
Date submitted
9/09/2014
Date registered
22/09/2014
Date last updated
22/09/2014
Type of registration
Retrospectively registered
Titles & IDs
Public title
Pharmacist demonstration of EpiPen and Anapen autoinjectors to simulated patients: assessment of accuracy.
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Scientific title
Pharmacist demonstration of EpiPen and Anapen autoinjectors to simulated patients: assessment of accuracy.
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Secondary ID [1]
285311
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None
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Anaphylaxis
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Condition category
Condition code
Inflammatory and Immune System
293293
293293
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0
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Allergies
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Intervention/exposure
Study type
Observational
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Patient registry
False
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Target follow-up duration
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Target follow-up type
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Description of intervention(s) / exposure
This is an observational study of pharmacist practice and performance in demonstrating adrenaline autoinjectors (EpiPen and Anapen) to simulated anaphylaxis patients.
Pharmacists were observed during a single consultation where a simulated patient requested advice on how to use an adrenaline autoinjector. Consultations lasted 5-15 minutes.
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Intervention code [1]
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Not applicable
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Comparator / control treatment
No control group as this is an observational study.
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Control group
Uncontrolled
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Outcomes
Primary outcome [1]
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Accurate demonstration (overall, i.e. for all devices) of all steps required for correct adrenaline autoinjector administration according to the steps for administration published on the (device specific) ASCIA Action Plan for Anaphylaxis.
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Assessment method [1]
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Timepoint [1]
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Upon request for demonstration by the simulated patient.
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Secondary outcome [1]
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Demonstration accuracy by device (original EpiPen, new-look EpiPen, Anapen). Accurate demonstration was defined as one that fulfilled all steps listed on the relevant Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plan for Anaphylaxis. A custom designed data collection tool (which we validated before use) captured demographic variables (broadly: pharmacy environment, pharmacist age group and gender), and adrenaline autoinjector variables (broadly: materials used for demonstration, use of references, steps used in demonstration, errors or omissions in demonstration and other advice provided).
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Assessment method [1]
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Timepoint [1]
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Upon request for demonstration
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Secondary outcome [2]
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Predictors of accurate demonstration based on the consultation with the pharmacist.
Binary logistic regression was performed to identify consultation-specific predictors of accurate EpiPen and Anapen demonstration. Potential predictors in the model were device type, age, gender, use of references, and general anaphylaxis and device-specific information provided by the pharmacist. Recognising that consultations with pharmacists may vary from brief to extended interactions (and thus to assess the impact of predictor variables independently and collectively), we conducted both single variable and multi variable (adjusted) logistic regression analyses. Odds ratios and 95% confidence intervals for each predictor were obtained.
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Assessment method [2]
310417
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Timepoint [2]
310417
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After data analysis - i.e. this will not be identified at the time of demonstration.
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Eligibility
Key inclusion criteria
Australian pharmacists working in community pharmacies, located within a 20km radius of the Perth Central Business District, and listed on the Pharmacy Registration Board of Western Australia Premises Register.
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Minimum age
20
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
Yes
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Key exclusion criteria
Pharmacists who are known to the researcher.
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Study design
Purpose
Natural history
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Duration
Cross-sectional
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Selection
Random sample
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Timing
Prospective
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Statistical methods / analysis
Accuracy to be analysed descriptively. Binary logistic regression will be used to identify predictors of accurate demonstration. There is no existing data upon which to estimate sample sizes, however we elected to sample the majority of pharmacies within the Perth metropolitan area (sample represented 96% of all pharmacies within a 20km radius of Perth CBD, and 73% of all Perth metropolitan pharmacies). No formal sample size calculations were performed.
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
12/03/2012
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Actual
12/03/2012
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Date of last participant enrolment
Anticipated
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Actual
4/05/2012
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
300
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Accrual to date
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Final
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Recruitment in Australia
Recruitment state(s)
WA
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Funding & Sponsors
Funding source category [1]
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Charities/Societies/Foundations
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Name [1]
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Pharmaceutical Society of Western Australia
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Address [1]
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21 Hamilton Street
Subiaco WA 6008
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Country [1]
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Australia
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Primary sponsor type
University
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Name
The University of Western Australia
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Address
Centre for Optimisation of Medicines
School of Medicine and Pharmacology
Division of Pharmacy
M315, The University of Western Australia
32 Stirling Highway
CRAWLEY WA 6009
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Country
Australia
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Secondary sponsor category [1]
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None
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Name [1]
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Address [1]
288622
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Country [1]
288622
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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UWA HREC
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Ethics committee address [1]
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The University of Western Australia 35 Stirling Highway CRAWLEY WA 6009
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Ethics committee country [1]
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Australia
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Date submitted for ethics approval [1]
291647
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Approval date [1]
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01/03/2012
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Ethics approval number [1]
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RA/4/1/5440
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Summary
Brief summary
Successful treatment of anaphylaxis in the community relies on early and correct use of epinephrine autoinjectors. Community pharmacists supply these devices with and without prescription and have a crucial role teaching patients how to use them. Supply of epinephrine autoinjectors in Australia increased 70-fold in the past decade. New EpiPen and Anapen autoinjectors were launched in Australia in 2011 and 2012, with the potential to cause confusion. However there is no information about how pharmacists demonstrate epinephrine autoinjectors to patients. Therefore the aim of this study was to assess real-world community pharmacist demonstrations of EpiPen and Anapen. We also sought to identify consultation-based predictors of accurate demonstration.
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Trial website
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Trial related presentations / publications
This work has been presented as follows: 1. Salter SM, Loh R, Sanfilippo FM, Clifford RM. Pharmacist demonstration of adrenaline autoinjectors is accurate, but there is room for improvement. ASCIA 2014 Annual Conference: Melbourne (AU); September 10-12, 2014. 2. Salter SM, Loh R, Sanfilippo FM, Clifford RM. Pharmacist demonstration of adrenaline autoinjectors is accurate, but there is room for improvement. Internal Medicine Journal 2014; 44 (S4): S1-29. 3. Salter SM, Loh R, Sanfilippo FM, Clifford RM. Demonstration of epinephrine autoinjectors (EpiPen and Anapen) by pharmacists in a randomised, simulated patient assessment: acceptable but room for improvement. Allergy, Asthma & Clinical Immunology 2014 (in press as at 18 September 2014).
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Public notes
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Contacts
Principal investigator
Name
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Ms Sandra Salter
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Address
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Centre for Optimisation of Medicines
School of Medicine and Pharmacology
Division of Pharmacy
M315, The University of Western Australia
35 Stirling Highway
CRAWLEY WA 6009
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Country
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Australia
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Phone
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+61 416 003 808
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Fax
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Email
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[email protected]
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Contact person for public queries
Name
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Sandra Salter
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Address
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Centre for Optimisation of Medicines
School of Medicine and Pharmacology
Division of Pharmacy
M315, The University of Western Australia
35 Stirling Highway
CRAWLEY WA 6009
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Country
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Australia
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Phone
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+61 416 003 808
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Fax
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Email
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[email protected]
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Contact person for scientific queries
Name
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Sandra Salter
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Address
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Centre for Optimisation of Medicines
School of Medicine and Pharmacology
Division of Pharmacy
M315, The University of Western Australia
35 Stirling Highway
CRAWLEY WA 6009
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Country
51336
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Australia
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Phone
51336
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+61 416 003 808
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Fax
51336
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Email
51336
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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