Clarification of Drug Allergy Information Using a Standardized Drug Allergy Questionnaire and Interview

P T. 2018 Aug;43(8):480-504.

Abstract

Background: Vague, incomplete, or inaccurate drug-allergy histories can be detrimental to patient safety and affect patient care. There is an increased chance of medication errors if details of a drug allergy are not documented. Incomplete or inaccurate allergy histories may also result in increased time spent by health care providers to clarify an order in question. Published literature from the early 1990s showed that a patient interview can facilitate collection of more complete allergy information and could lead to the removal of a documented drug allergy in approximately one-third of patients.

Purpose: This quality-improvement project was conducted to improve the process of collecting drug-allergy information at our institution.

Description: The primary objective of this project was to determine the number of patients with a clinically relevant change in allergy history after a standardized drug-allergy questionnaire and interview compared with documentation prior to the interview. This was a descriptive, prospective quality improvement project of a standardized drug-allergy questionnaire and interview. Patients were asked about the history of their allergic reaction, including the drug, route, nature of reaction, treatment of reaction, and time since reaction.

Results: A total of 301 patient allergy profiles were reviewed. After screening, 202 patients were included and interviewed, for a total of 509 drug allergies. One hundred twenty-three patients (61%) had a need for a clinically relevant change in allergy history after an interview. A total of 228 changes were made to patient allergy profiles. Adding the allergy reaction accounted for 131 of the changes. Also, there were 185 allergies documented prior to the interview that were categorized as unclear/vague, which was significantly reduced to 112 after the interview (P < 0.0001).

Conclusion: More complete drug-allergy information was obtained after executing a standardized drug-allergy questionnaire and interview.

Keywords: drug allergy; patient interview; quality improvement.