Action plans for the long-term management of anaphylaxis: systematic review of effectiveness

Clin Exp Allergy. 2007 Jul;37(7):1090-4. doi: 10.1111/j.1365-2222.2007.02711.x.


Background: Anaphylaxis is a severe, potentially life-threatening allergic reaction. Most reactions occur in the absence of a healthcare professional and there is a considerable risk of recurrence in those with a past history of anaphylaxis. The concept of action plans has been developed to facilitate long-term self-management of chronic disorders with a view to promoting patient empowerment and improving health outcomes. Although increasingly advocated for use in anaphylaxis, the effectiveness of this approach in this context is unknown.

Objectives: To assess the effectiveness of action plans as part of the long-term self-management of anaphylaxis in improving health outcomes.

Methods: Standard systematic review techniques were used. We searched CENTRAL, Cochrane, Medline and Embase databases, contacted an international panel of anaphylaxis experts and relevant pharmaceutical companies and searched key web-based databases of trials (, and for published, unpublished and on-going randomized or quasi-randomized controlled trials of action plans in anaphylaxis management. There was no restriction used with respect to the language of publication. Searches were completed in summer 2006.

Results: None of the 1026 potentially relevant studies identified fulfilled the inclusion criteria for this review.

Conclusions: Although there are potential major benefits of routinely issuing anaphylaxis action plans, there is currently no robust evidence to guide clinical practice. Pragmatic randomized-controlled trials of anaphylaxis action plans are urgently needed; in the meantime, national and international guidelines should make clear this major gap in the evidence base.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Anaphylaxis / therapy*
  • Chronic Disease
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Long-Term Care / organization & administration*
  • Organizational Objectives*
  • Outcome and Process Assessment, Health Care*
  • Patient Education as Topic
  • Practice Guidelines as Topic
  • Program Evaluation
  • Quality of Health Care*
  • Recurrence
  • Research Design
  • Self Care