How many patients who claim to have drug allergy have a true allergy?
A Aslanyan and M Thomas
Scunthorpe General Hospital (SGH), UK
: J Immunol Tech Infect Dis
Abstract
Introduction: The incidence of an allergic reaction to antibiotics is as high as 5-10%1. Interestingly, a significant number of patients are under the impression that they are allergic to certain medications, but in fact, some of these cases are not true allergies but side effects. False drug allergy status can potentially compromise patients’ care and increase healthcare expenses. Objective: This audit looks at 1) how well allergy status is recorded in medical and surgical wards at SGH2) are the appropriate red wristbands given? 3) What is the percentage of patients who are labelled as ‘allergic to certain medications’ have a true allergy? Method: Data was collected from 99 random medical inpatients and 101 random surgical inpatients using our designed proforma. The proforma asked the following questions: 1) Does the patient claim to have allergy? 2) If yes - what reaction is it? 3) Is the allergy status recorded in clerking sheet and drug chart? 4) Is the allergic reaction recorded? 5) Are appropriate wristbands given to the patients? Results: 30% of patients claimed that they have allergy. Only 89% and 97% of allergy status was recorded in clerking sheets and drug charts respectively. Out of the patients who had an allergy only 33.3% of allergic reactions was recorded. Only 40.3% of patients had true allergy (anaphylaxis; breathlessness; rash; swollen lips, face, etc.) and the rest had side effects which they thought are allergic reactions (e.g. stomach pain, muscle ache, sweating, diarrhoea and vomiting, etc.). Out of the patients who had an allergy 16.7% could not remember the allergic reaction and another 8.3% were not even aware that they had drug allergy even though it was mentioned in the notes. Overall 6% of patients did not have appropriate red wristbands on and another 6% of patients did not know that they have allergy. Conclusion: According to the data only 1/3 of patients had the type of reaction recorded. Almost 35% of patients who were labelled as ‘allergic to certain drug’ had a false allergy. These data showed that it is very important to give appropriate wristbands to the patients with allergy because sometimes they do not remember/know that they have drug allergy. For optimal management of infectious diseases, the choice of most suitable antibiotic is essential. This audit aimed to highlight the importance of detailed record of allergy status and the potential implications in patients’ safety. References: 1) Romano A, Warrington R 2014, ‘Antibiotic Allergy’, Immunology and allergy clinics of North America, V34, pp. 489-506.
Biography
A Aslanyan started working in Scunthorpe General Hospital as a Foundation Year 1 doctor. A Aslanyan already had rotations in Urology department (where he did the audit that he is going to present) and Gynaecology department. At the moment he is working in elderly medicine and stroke unit. He is moving to Hull in August 2015 for his Foundation Year 2 where he is going to have rotations in Accident and Emergency, Psychiatry and Neurosurgery.
E mail: aram.aslanyan@doctors.org.uk
