Development and Validation of a Mobile Clinical Decision Support Tool for the Diagnosis of Drug Allergy in Adults: The Drug Allergy App

Penicillin Allergy label - the unmet needs - causes and potential solutions

“…On the other hand, the survey also found that majority of the doctors in this study were confident in taking, interpreting, and drawing a firm conclusion on an allergy based on a patient's history alone. This differs to findings by Elkhalifa et al, as this study reported that most clinicians (55.2%) believed that it not possible to use history alone to decide a patients allergy status (13). The survey also explored a number of potential solutions which may help doctors to feel more confident in appropriately de-labelling patients with an inappropriate penicillin allergy label, these include the use of educational material, or decision support tools in the form of web-based algorithm, drug allergy app or flow charts.…”

“…The audit also evidenced that no patients in this cohort had been referred to drug allergy services, although 24% (13/54) fulfilled the NICE CG183 criteria for referral (11). This supports research from a study by Elkhalifa et al who found that in a UK hospital over 60% of clinicians had not referred any patients to a specialist drug allergy service over the last year (13). This audit therefore supports the findings of other studies, that in practice, there is a clear stray from the NICE CG183 for documenting, managing, and referring patients with penicillin allergies.…”

“…is limited in its relevance, as it only explored the views of junior doctors, who are still in training, and did not include other prescribing clinicians. It found varying results to studies by Elkhlaifa et al, and this may be due to the lack of role diversity in this survey, as their survey included doctors in training, consultants, and non-medical prescribers (13). The level of training may impact the results, as studies undertaken by Elkhalifa et al and Amin et al have correlated a lack of training to the inappropriate management allergies (13,15).…”

“…The high prevalence of patients with a penicillin allergy label raises the important query into whether these standards of best practice are being met. There are numerous studies which evidence widespread inconsistency in the documentation of drug allergies, and low referral rates of patients to allergy specialist services (11)(12)(13). A study by MacLaughlin et al included a total of 660 patients, 99 having a recorded penicillin allergy but only 33% had some form of evaluation and description of their suspected allergic reaction (12).…”

“…A study by MacLaughlin et al included a total of 660 patients, 99 having a recorded penicillin allergy but only 33% had some form of evaluation and description of their suspected allergic reaction (12). Further to this, a study by Elkhalifa et al found that in a UK hospital, over 60% of clinicians had not referred any patients to a specialist drug allergy service (13).…”