Drug Allergy Alert System in a Spanish University Hospital: Description and Dynamics of Use

Abstract

<b><i>Introduction:</i></b> The drug allergy alert system reduces the frequency of adverse drug events, although it is subjected to collateral effects, since 80–90% of alerts are not real, and a large percentage of alerts are overridden (46.2–96.2%). We reviewed how the alert system is used at University Hospital Fundación Alcorcon (HUFA). <b><i>Methods:</i></b> Data were obtained from the drug allergy alert and the alert overriding notification forms (both in the period 2011–20). We also recorded drug allergy diagnoses at HUFA, drug consumption in primary care in 2016. We calculated the incidence of drug allergy alert activation, temporal trends in use, and correlations between the number of drugs in several datasets. <b><i>Results:</i></b> We collected 15,535 alerts. NSAIDs and penicillins were the drugs with the highest number of drug allergy alerts (36.55% and 26.91%, respectively). A correlation was found between the number of drug alerts and the type of drug allergy in HUFA in 2016. Only 6.83% of the alerts were removed, and, of these, 21.77% were reactivated. Approximately 100 overrides were recorded per year from 2016 (6.8% of 8,434 activated alerts during 2014–2020). <b><i>Conclusions:</i></b> The number of drug allergy alerts recorded via the drug allergy alert system of HUFA correlates with the distribution of drug allergy diagnoses in the hospital, although many of the alerts could be false positives (as per current published evidence). We detected a very low frequency of removed alerts (6.83%), a relevant frequency of reactivations (one quarter), and a very low frequency of overrides (6.8%).

How Far Are We From Achieving Delabeling of False Penicillin/ß-Lactam Allergy Alerts? A Population Problem

“…The experience of our group and of other authors shows that ≤20% of removed penicillin allergy alerts are reactivated [64,65].…”