{"id":"https://openalex.org/W7225589728","doi":"https://doi.org/10.70164/ihsr.v2i6.267","title":"Anaphylaxis and epinephrine autoinjectors: use, access, and disparities in health care in Brazil and worldwide","display_name":"Anaphylaxis and epinephrine autoinjectors: use, access, and disparities in health care in Brazil and worldwide","publication_year":2026,"publication_date":"2026-11-07","ids":{"openalex":"https://openalex.org/W7225589728","doi":"https://doi.org/10.70164/ihsr.v2i6.267"},"language":"en","primary_location":{"id":"doi:10.70164/ihsr.v2i6.267","doi":"https://doi.org/10.70164/ihsr.v2i6.267","is_oa":true,"landing_page_url":"https://doi.org/10.70164/ihsr.v2i6.267","pdf_url":"https://internationalhsr.com/index.php/ojs/article/download/267/244","source":{"id":"https://openalex.org/S5407049737","display_name":"International Health Sciences Review","issn_l":"3085-9018","issn":["3085-9018"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4404677168","host_organization_name":"Nilton Lins University","host_organization_lineage":["https://openalex.org/P4404677168"],"host_organization_lineage_names":["Nilton Lins University"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Health Sciences Review","raw_type":"journal-article"},"volume":null,"type":"article","is_traditional":true,"indexed_in":["crossref"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://internationalhsr.com/index.php/ojs/article/download/267/244","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5036924194","display_name":"M\u00e1rcio Pimentel Rocha","orcid":"https://orcid.org/0009-0008-3680-9035","observed_orcids":["https://orcid.org/0009-0008-3680-9035"]},"institutions":[{"id":"https://openalex.org/I4405286412","display_name":"Universidad Central del Paraguay","ror":"https://ror.org/022gxe522","country_code":"PY","type":"education","lineage":["https://openalex.org/I4405286412"]}],"countries":["PY"],"is_corresponding":false,"raw_author_name":"M\u00e1rcio Pimentel Rocha","raw_affiliation_strings":["Universidad Central del Paraguay , Paraguay"],"raw_orcid":"https://orcid.org/0009-0008-3680-9035","affiliations":[{"raw_affiliation_string":"Universidad Central del Paraguay , Paraguay","institution_ids":["https://openalex.org/I4405286412"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5104347440","display_name":"Ana Clara Pessoa Pontes","orcid":"https://orcid.org/0009-0003-2970-7819","observed_orcids":["https://orcid.org/0009-0003-2970-7819"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ana Clara Pessoa Pontes","raw_affiliation_strings":[],"raw_orcid":"https://orcid.org/0009-0003-2970-7819","affiliations":[]},{"author_position":"middle","author":{"id":"https://openalex.org/A5117269975","display_name":"Yuri Gabriel Vier","orcid":"https://orcid.org/0009-0002-0361-6153","observed_orcids":["https://orcid.org/0009-0002-0361-6153"]},"institutions":[{"id":"https://openalex.org/I4405286412","display_name":"Universidad Central del Paraguay","ror":"https://ror.org/022gxe522","country_code":"PY","type":"education","lineage":["https://openalex.org/I4405286412"]}],"countries":["PY"],"is_corresponding":false,"raw_author_name":"Yuri Gabriel Vier","raw_affiliation_strings":["Universidad Central del Paraguay , Paraguay"],"raw_orcid":"https://orcid.org/0009-0002-0361-6153","affiliations":[{"raw_affiliation_string":"Universidad Central del Paraguay , Paraguay","institution_ids":["https://openalex.org/I4405286412"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5071491107","display_name":"Tamara Cotrim Marques","orcid":"https://orcid.org/0009-0004-4655-2385","observed_orcids":["https://orcid.org/0009-0004-4655-2385"]},"institutions":[{"id":"https://openalex.org/I4405286412","display_name":"Universidad Central del Paraguay","ror":"https://ror.org/022gxe522","country_code":"PY","type":"education","lineage":["https://openalex.org/I4405286412"]}],"countries":["PY"],"is_corresponding":false,"raw_author_name":"Tamara Cotrim Marques","raw_affiliation_strings":["Universidad Central del Paraguay , Paraguay"],"raw_orcid":"https://orcid.org/0009-0004-4655-2385","affiliations":[{"raw_affiliation_string":"Universidad Central del Paraguay , Paraguay","institution_ids":["https://openalex.org/I4405286412"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5150867563","display_name":"Thallys Eduardo Lucht Klauck","orcid":"https://orcid.org/0009-0001-6002-0092","observed_orcids":["https://orcid.org/0009-0001-6002-0092"]},"institutions":[{"id":"https://openalex.org/I4405259110","display_name":"Universidad Mar\u00eda Auxiliadora","ror":"https://ror.org/01rnnvr75","country_code":"PY","type":"education","lineage":["https://openalex.org/I4405259110"]}],"countries":["PY"],"is_corresponding":false,"raw_author_name":"Thallys Eduardo Lucht Klauck","raw_affiliation_strings":["Universidad Mar\u00eda Auxiliadora , Paraguay"],"raw_orcid":"https://orcid.org/0009-0001-6002-0092","affiliations":[{"raw_affiliation_string":"Universidad Mar\u00eda Auxiliadora , Paraguay","institution_ids":["https://openalex.org/I4405259110"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5136667509","display_name":"Larissa Leite da Veiga","orcid":"https://orcid.org/0009-0004-5462-5847","observed_orcids":["https://orcid.org/0009-0004-5462-5847"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Larissa Leite da Veiga","raw_affiliation_strings":["Universidad Tres Fronteras , Paraguay"],"raw_orcid":"https://orcid.org/0009-0004-5462-5847","affiliations":[{"raw_affiliation_string":"Universidad Tres Fronteras , Paraguay","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5161285711","display_name":"Jackeline Marques Wenceslau","orcid":"https://orcid.org/0009-0002-0487-3012","observed_orcids":["https://orcid.org/0009-0002-0487-3012"]},"institutions":[{"id":"https://openalex.org/I4210161278","display_name":"Universidad de la Integraci\u00f3n de las Am\u00e9ricas","ror":"https://ror.org/05r9r2h28","country_code":"PY","type":"education","lineage":["https://openalex.org/I4210161278"]}],"countries":["PY"],"is_corresponding":false,"raw_author_name":"Jackeline Marques Wenceslau","raw_affiliation_strings":["Universidad de la Integraci\u00f3n de las Am\u00e9ricas , Paraguay"],"raw_orcid":"https://orcid.org/0009-0002-0487-3012","affiliations":[{"raw_affiliation_string":"Universidad de la Integraci\u00f3n de las Am\u00e9ricas , Paraguay","institution_ids":["https://openalex.org/I4210161278"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":{"value":0.0,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"2","issue":"6","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10634","display_name":"Food Allergy and Anaphylaxis Research","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2723","display_name":"Immunology and Allergy"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10634","display_name":"Food Allergy and Anaphylaxis Research","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2723","display_name":"Immunology and Allergy"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11117","display_name":"Drug-Induced Adverse Reactions","score":0.00039999998989515007,"subfield":{"id":"https://openalex.org/subfields/2736","display_name":"Pharmacology (medical)"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10877","display_name":"Allergic Rhinitis and Sensitization","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2723","display_name":"Immunology and Allergy"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/anaphylaxis","display_name":"anaphylaxis","score":1.0},{"id":"https://openalex.org/keywords/epinephrine-auto-injector","display_name":"epinephrine auto-injector","score":0.9879999756813049},{"id":"https://openalex.org/keywords/health-care-disparities","display_name":"health care disparities","score":0.8379999995231628},{"id":"https://openalex.org/keywords/brazil","display_name":"Brazil","score":0.8939999938011169},{"id":"https://openalex.org/keywords/cross-national-comparison","display_name":"cross-national comparison","score":0.6010000109672546},{"id":"https://openalex.org/keywords/regulatory-challenges","display_name":"regulatory challenges","score":0.6060000061988831},{"id":"https://openalex.org/keywords/import-dependency","display_name":"import dependence","score":0.5910000205039978},{"id":"https://openalex.org/keywords/equipment-availability","display_name":"equipment availability","score":0.5559999942779541},{"id":"https://openalex.org/keywords/patient-training","display_name":"patient training","score":0.8960000276565552},{"id":"https://openalex.org/keywords/continuity-of-care","display_name":"continuity of care","score":0.7889999747276306},{"id":"https://openalex.org/keywords/anaphylaxis-epidemiology","display_name":"anaphylaxis epidemiology","score":0.8500000238418579},{"id":"https://openalex.org/keywords/anaphylaxis-registry","display_name":"anaphylaxis registry","score":0.6190000176429749},{"id":"https://openalex.org/keywords/health-equity","display_name":"health equity","score":0.531000018119812}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.8482999801635742},{"id":"https://openalex.org/C2775933838","wikidata":"https://www.wikidata.org/wiki/Q168800","display_name":"Anaphylaxis","level":3,"score":0.8482999801635742},{"id":"https://openalex.org/C107130276","wikidata":"https://www.wikidata.org/wiki/Q133805","display_name":"Epidemiology","level":2,"score":0.7455999851226807},{"id":"https://openalex.org/C2775859304","wikidata":"https://www.wikidata.org/wiki/Q132621","display_name":"Epinephrine","level":2,"score":0.7059000134468079},{"id":"https://openalex.org/C160735492","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Health care","level":2,"score":0.5706999897956848},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.5031999945640564},{"id":"https://openalex.org/C99454951","wikidata":"https://www.wikidata.org/wiki/Q932068","display_name":"Environmental health","level":1,"score":0.3968000113964081},{"id":"https://openalex.org/C138816342","wikidata":"https://www.wikidata.org/wiki/Q189603","display_name":"Public health","level":2,"score":0.35929998755455017},{"id":"https://openalex.org/C545542383","wikidata":"https://www.wikidata.org/wiki/Q2751242","display_name":"Medical emergency","level":1,"score":0.3531999886035919},{"id":"https://openalex.org/C512399662","wikidata":"https://www.wikidata.org/wiki/Q3505712","display_name":"Family medicine","level":1,"score":0.35249999165534973},{"id":"https://openalex.org/C83864248","wikidata":"https://www.wikidata.org/wiki/Q177323","display_name":"Developing country","level":2,"score":0.3522999882698059},{"id":"https://openalex.org/C62558387","wikidata":"https://www.wikidata.org/wiki/Q821775","display_name":"Epidemiological surveillance","level":3,"score":0.34049999713897705},{"id":"https://openalex.org/C3020000205","wikidata":"https://www.wikidata.org/wiki/Q2412849","display_name":"Narrative review","level":2,"score":0.32899999618530273},{"id":"https://openalex.org/C160050368","wikidata":"https://www.wikidata.org/wiki/Q132453","display_name":"Developed country","level":3,"score":0.3091999888420105},{"id":"https://openalex.org/C2989236134","wikidata":"https://www.wikidata.org/wiki/Q31207","display_name":"Patient care","level":2,"score":0.29649999737739563},{"id":"https://openalex.org/C761482","wikidata":"https://www.wikidata.org/wiki/Q118093","display_name":"Transmission (telecommunications)","level":2,"score":0.29269999265670776},{"id":"https://openalex.org/C2779473830","wikidata":"https://www.wikidata.org/wiki/Q1540899","display_name":"MEDLINE","level":2,"score":0.29190000891685486},{"id":"https://openalex.org/C190248442","wikidata":"https://www.wikidata.org/wiki/Q839486","display_name":"Qualitative research","level":2,"score":0.2849000096321106},{"id":"https://openalex.org/C45555294","wikidata":"https://www.wikidata.org/wiki/Q28113351","display_name":"Inequality","level":2,"score":0.2840000092983246},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.2614000141620636}],"mesh":[],"locations_count":1,"locations":[{"id":"doi:10.70164/ihsr.v2i6.267","doi":"https://doi.org/10.70164/ihsr.v2i6.267","is_oa":true,"landing_page_url":"https://doi.org/10.70164/ihsr.v2i6.267","pdf_url":"https://internationalhsr.com/index.php/ojs/article/download/267/244","source":{"id":"https://openalex.org/S5407049737","display_name":"International Health Sciences Review","issn_l":"3085-9018","issn":["3085-9018"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4404677168","host_organization_name":"Nilton Lins University","host_organization_lineage":["https://openalex.org/P4404677168"],"host_organization_lineage_names":["Nilton Lins University"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Health Sciences Review","raw_type":"journal-article"}],"best_oa_location":{"id":"doi:10.70164/ihsr.v2i6.267","doi":"https://doi.org/10.70164/ihsr.v2i6.267","is_oa":true,"landing_page_url":"https://doi.org/10.70164/ihsr.v2i6.267","pdf_url":"https://internationalhsr.com/index.php/ojs/article/download/267/244","source":{"id":"https://openalex.org/S5407049737","display_name":"International Health Sciences Review","issn_l":"3085-9018","issn":["3085-9018"],"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/P4404677168","host_organization_name":"Nilton Lins University","host_organization_lineage":["https://openalex.org/P4404677168"],"host_organization_lineage_names":["Nilton Lins University"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"International Health Sciences Review","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"display_name":"Good health and well-being","id":"https://metadata.un.org/sdg/3"},{"score":0.7578999996185303,"display_name":"Reduced inequalities","id":"https://metadata.un.org/sdg/10"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225589728.pdf","grobid_xml":"https://content.openalex.org/works/W7225589728.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W4387815155","https://openalex.org/W2144014231","https://openalex.org/W7166290334","https://openalex.org/W2124366807","https://openalex.org/W2988964799","https://openalex.org/W2753704976","https://openalex.org/W2012666820","https://openalex.org/W4297172850","https://openalex.org/W2900870629","https://openalex.org/W3167277264"],"abstract_inverted_index":{"Anaphylaxis":[0,101],"is":[1,12],"a":[2],"potentially":[3],"fatal":[4],"systemic":[5],"hypersensitivity":[6],"reaction":[7],"for":[8],"which":[9],"intramuscular":[10],"epinephrine":[11,27,107],"the":[13,21,128,137],"first-line":[14],"treatment.":[15],"This":[16],"review":[17,40],"aimed":[18],"to":[19,26,143],"analyze":[20],"use":[22,115],"of":[23,81,111,140,162],"and":[24,33,50,52,67,97,120,160,167],"access":[25,126,148,170],"autoinjectors,":[28],"emphasizing":[29],"disparities":[30],"between":[31,95],"Brazil":[32],"other":[34],"countries.":[35],"A":[36],"qualitative":[37],"narrative":[38],"literature":[39],"was":[41],"conducted":[42],"using":[43],"clinical":[44],"guidelines,":[45],"epidemiological":[46,165],"studies,":[47],"international":[48,71],"surveys,":[49],"institutional":[51],"regulatory":[53],"documents.":[54],"The":[55,99],"findings":[56],"revealed":[57],"substantial":[58],"inequalities":[59],"in":[60,79,85,109,116],"autoinjector":[61,114],"availability,":[62],"associated":[63],"with":[64],"economic,":[65],"regulatory,":[66],"healthcare":[68],"barriers.":[69],"An":[70],"survey":[72],"involving":[73],"66":[74],"countries":[75],"reported":[76],"device":[77,152],"availability":[78],"60%":[80],"participating":[82],"countries,":[83],"predominantly":[84],"higher-income":[86],"settings.":[87],"In":[88],"Brazil,":[89],"5,716":[90],"anaphylaxis-related":[91],"hospitalizations":[92],"were":[93],"recorded":[94],"2011":[96],"2019.":[98],"Brazilian":[100],"Registry,":[102],"comprising":[103],"237":[104],"patients,":[105],"documented":[106],"administration":[108],"61.1%":[110],"cases,":[112],"including":[113],"8.4%.":[117],"Regulatory":[118],"restrictions":[119],"dependence":[121],"on":[122],"importation":[123],"further":[124],"complicated":[125],"during":[127],"periods":[129],"examined.":[130],"However,":[131],"available":[132],"evidence":[133],"does":[134],"not":[135],"establish":[136],"individual":[138],"contribution":[139],"these":[141],"barriers":[142],"treatment":[144],"outcomes.":[145],"Ensuring":[146],"effective":[147],"requires":[149],"more":[150],"than":[151],"commercialization,":[153],"encompassing":[154],"appropriate":[155],"prescription,":[156],"affordability,":[157],"patient":[158],"training,":[159],"continuity":[161],"care.":[163],"Strengthening":[164],"surveillance":[166],"developing":[168],"equitable":[169],"strategies":[171],"remain":[172],"important":[173],"priorities.":[174]},"counts_by_year":[],"updated_date":"2026-11-10T11:39:43.021295","created_date":"2026-11-09T00:00:00"}
