%0 Journal Article %A Sarah Burrell %A Nandinee Patel %A Marta Vazquez-Ortiz %A Dianne E. Campbell %A Audrey DunnGalvin %A Paul J. Turner %T Self-administration of adrenaline for anaphylaxis during in-hospital food challenges improves health-related quality of life %D 2021 %R 10.1136/archdischild-2020-319906 %J Archives of Disease in Childhood %P 558-563 %V 106 %N 6 %X Objective To assess the impact of anaphylaxis on health-related quality of life (HRQL) and self-efficacy in food-allergic patients undergoing in-hospital food challenge.Design Secondary analysis of a randomised controlled trial.Setting Specialist allergy centre.Patients Peanut-allergic young people aged 8–16 years.Interventions Double-blind, placebo-controlled food challenge to peanut, with HRQL and self-efficacy assessed using validated questionnaire, approximately 2 weeks prior to and 2 weeks after challenge. Where possible, anaphylaxis was treated with self-injected adrenaline (epinephrine).Main outcome measures Change in HRQL and self-efficacy.Results 56 participants had reactions at food challenge, of whom 16 (29%) had anaphylaxis. Overall, there was an improvement in HRQL (mean 2.6 points (95% CI 0.3 to 4.8); p=0.030) and self-efficacy (mean 4.1 points (95% CI 2.4 to 5.9); p<0.0001), independent of whether anaphylaxis occurred. Parents also reported improved HRQL (mean 10.3 points (95% CI 5.9 to 14.7); p<0.0001). We found evidence of discordance between the improvement in HRQL and self-efficacy as reported by young people and that perceived by parents in their child.Conclusions Anaphylaxis at food challenge, followed by self-administration of injected adrenaline, was associated with an increase in HRQL and self-efficacy in young people with peanut allergy. We found no evidence that the occurrence of anaphylaxis had a detrimental effect. Young people should be encouraged to self-administer adrenaline using their autoinjector device to treat anaphylaxis at in-hospital challenge.Trial registration number NCT02149719 Anonymised data are available on reasonable request, from the corresponding author. %U https://adc.bmj.com/content/archdischild/106/6/558.full.pdf