Individual research recommendation details

Recommendation ID

CG183/1

Question

Designing systems for documenting drug allergy:- Which documentation strategies would be most clinically and cost effective to minimise the number of people who are re-exposed to drugs to which they have a suspected or confirmed allergy, looking in particular at:
- electronic health records that include features specifically designed to record and alert
clinicians to drug allergy information, compared with systems without such features and
- different formats for patient-held, structured drug allergy documentation?

Any explanatory notes
(if applicable)

Evidence from patient safety incident reports to the National Reporting and Learning System and
from published research shows that a large number of NHS patients with known drug allergies are being re-exposed to these drugs in error each year. Over the past few decades, many people have been inaccurately diagnosed and recorded as either having or not having a drug allergy. While re-exposure to a drug has not caused harm in the majority of people, a minority of these incidents have caused harm or death.
The systematic review undertaken for this guideline identified a wide range of documentation strategies, including patient-held records; information worn by patients; hospital-based notices worn by patients (such as coloured arm bands); automated messages (for example, screensavers); mandatory reporting of drug allergy status in paper or electronic medication records; mandatory documentation of details related to adverse drug reactions; design of drug charts; use of Summary Care Records; and computerised physician or prescriber order entry (CPOE) systems.
Most of the studies included in the systematic review were from the USA and their focus was largely on adverse drug events or medication prescribing errors, and not specifically on drug allergy. In addition, few studies assessed the effectiveness of patient-held documentation strategies. The quality of the evidence from studies was generally very low. Research is therefore needed to determine which strategy or combination of strategies is most effective in reducing harm by minimising accidental re-exposure to a known drug allergen.

Source guidance details

Comes from guidance

Drug allergy: diagnosis and management

Number

CG183

Date issued

September 2014

Other details