Young people's views on the design of adrenaline auto-injectors: A qualitative study

Background: Young people’s compliance with carriage of adrenaline auto-injectors (AAI) may be as low as 41%, yet we lack research exploring their preferences regarding these devices. Objective: This qualitative study explored young people’s ideas about AAI design and features which may facilitate their carriage and use. Methods: Young people aged 13-18 years prescribed an AAI for severe allergic reaction were invited to participate in in-depth, semi-structured, face-to-face interviews about AAI design. Interviews were recorded, transcribed verbatim and analyzed using thematic content analysis. Results: From 23 interviews, seven major themes were identified: accessibility and carriage, comprehensibility of instructions, indication of correct administration, safety, speed of administration, visibility and identification and precise drug delivery. Young people made several suggestions for how AAIs may be adapted to improve carriage, including reduced size to enable pocket-carriage. Comprehensibility was thought to be enhanced by the use of pictographic instructions and audio-prompts to encourage prompt and accurate administration. Needle guards were seen as beneficial to reduce needle phobia, prevent accidental injury and provide reassurance that the device had been administered. Young people were conflicted between wanting a device which enabled discreet carriage, versus an AAI which was bold and clearly identifiable as a medical device in case of emergency. Conclusion: This study identified key AAI features important to young people, together with design issues deterring day-to-day carriage of AAIs and their emergency, time-pressured usage. We demonstrated considerable scope for AAI design modifications to improve young peoples’ perception of devices and facilitate their carriage and use.