Manning Jessica, Pammett Robert T, Hamour Abu Obeida, Enemark Aleisha, Barr Barret
, BSc(Pharm), ACPR, is with the University Hospital of Northern British Columbia, Northern Health, Prince George, British Columbia.
, BSc, BSP, MSc, BCGP, is with Northern Health, Prince George, British Columbia, and the Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia.
Can J Hosp Pharm. 2021 Spring;74(2):104-109. Epub 2021 Apr 1.
Inappropriate allergy labelling is associated with significant clinical and pharmacoeconomic implications. Detailed antimicrobial allergy assessments represent a key component of antimicrobial stewardship and aid in identifying true type I (immediate hypersensitivity) reactions. The allergy history form currently used at the University Hospital of Northern British Columbia (UHNBC), in Prince George, relies on the assessor's ability to ask appropriate prompting questions to obtain a thorough history, but it may not be sufficient to accurately identify true allergies.
To compare a standardized allergy history questionnaire and the current allergy history form in terms of the quality and quantity of documentation gathered.
This prospective observational study involved patients who were admitted to medical and surgical services at UHNBC from November 2018 to January 2019 with a penicillin-class allergy reported on their electronic medical record (EMR). A list of patients with EMR-reported allergies was generated by the hospital's health information software system, and these patients were interviewed using the standardized allergy history questionnaire.
A total of 48 patients were assessed during the study period. Nineteen (40%) of the patients had an inappropriate allergy label on their EMR. Only 36 (75%) had an allergic reaction described on their EMR. Furthermore, only 36 (75%) of the 48 patients had the same allergy recorded on the EMR and on the allergy history form contained in their paper chart, of whom 22 had a documented reaction. The mean time to complete the standardized allergy history questionnaire was 2 minutes.
At the study institution, documentation of allergy histories was often incomplete. Detailed allergy assessments are the first step in identifying true immunoglobulin E-mediated hypersensitivity reactions. Utilization of a standardized allergy history questionnaire is feasible and may serve to improve documentation and overall antimicrobial stewardship.
不恰当的过敏标签具有重大的临床和药物经济学意义。详细的抗菌药物过敏评估是抗菌药物管理的关键组成部分，有助于识别真正的I型（速发型超敏反应）。不列颠哥伦比亚省北部大学医院（UHNBC）位于乔治王子城，目前使用的过敏史表格依赖评估者提出恰当的提示性问题来获取完整病史，但可能不足以准确识别真正的过敏情况。
比较标准化过敏史问卷和当前过敏史表格在收集的记录质量和数量方面的差异。
这项前瞻性观察性研究纳入了2018年11月至2019年1月在UHNBC内科和外科住院且电子病历（EMR）报告有青霉素类过敏的患者。医院的健康信息软件系统生成了EMR报告有过敏的患者名单，并使用标准化过敏史问卷对这些患者进行访谈。
研究期间共评估了48例患者。其中19例（40%）患者的EMR上有不恰当的过敏标签。只有36例（75%）患者的EMR上描述了过敏反应。此外，48例患者中只有36例（75%）在EMR和纸质病历中的过敏史表格上记录了相同的过敏情况，其中22例有记录的反应。完成标准化过敏史问卷的平均时间为2分钟。
在研究机构中，过敏史记录往往不完整。详细的过敏评估是识别真正的免疫球蛋白E介导的超敏反应的第一步。使用标准化过敏史问卷是可行的，可能有助于改善记录并加强整体抗菌药物管理。
