D1.295 - Patient Perceived Lifestyle Burden with a Nasal Adrenaline Spray vs an Adrenaline Auto- Injector

Carrying adrenaline-delivery devices can impose social and emotional burdens that influence willingness to carry and use those devices. Traditional adrenaline auto-injectors (AAIs) may bring stigma, visibility concerns, and practical maintenance demands. This study aimed to assess whether a nasal adrenaline spray (NAS), a needle-free alternative to an AAI, can help reduce some of these burdens.

90 participants from the UK took part: 30 children, 30 adults, and 30 caregivers, with 60 having a known severe allergy or caring for someone with allergy. All participants watched the official “how to use” videos and simulated, or watched someone simulate, two administrations with both an AAI and a NAS using trainer devices. Participants rated lifestyle-impact statements on a 5-point Likert scale. Nine lifestyle domains were assessed: stigma, comfort telling colleagues, comfort telling friends, discretion of public use, lack of embarrassment being seen using, disposal ease, burden of checking stability/expiry, liking the appearance, and increasing willingness to carry.

The participants reported that the NAS is not stigmatising (NAS:87%, AAI:27%), and that they feel more comfortable telling friends (NAS:96%, AAI:86%) and colleagues (NAS:95%, AAI:75%) they have a NAS compared to an AAI. The NAS was rated more discrete to use in public (NAS:93%, AAI:9%), and even if people saw them use it, more participants reported that the NAS is not embarrassing (NAS:89%, AAI:69%). Furthermore, the NAS was rated easier to dispose of (NAS:100%, AAI:7%), and less of a burden to maintain (NAS:82%, AAI:42%). More participants liked how it looks (NAS:71%, AAI:18%) and agreed that the appearance of the NAS makes them more willing to carry it (NAS:69%, AAI:17%). NAS was rated significantly higher on all nine aspects (p<0.001). The preference for NAS was consistent across adults, children, caregivers, and both allergy-experienced and allergy-naïve groups.

The NAS was consistently perceived as having a lower lifestyle burden than the AAI. The NAS was further perceived to be more likely to blend into their routines without adding complexity thus supporting immediate use in an emergency of anaphylaxis.