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1003. Impact of a Standardized Pharmacist-led Β-lactam Allergy Interview on the Quality of Allergy Documentation
BACKGROUND: Reported β-lactam allergies are common and are associated with inappropriate antibiotic therapy, poor clinical outcomes, and increased hospital costs. Documentation of β-lactam reactions is often incomplete and many patients with a reported allergy can tolerate a β-lactam antibiotic. Thi...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6811115/ http://dx.doi.org/10.1093/ofid/ofz360.867 |
Sumario: | BACKGROUND: Reported β-lactam allergies are common and are associated with inappropriate antibiotic therapy, poor clinical outcomes, and increased hospital costs. Documentation of β-lactam reactions is often incomplete and many patients with a reported allergy can tolerate a β-lactam antibiotic. This study aims to evaluate the impact of a standardized interviewing tool used by pharmacists on the quality of β-lactam allergy documentation. METHODS: This is a single-center, prospective, quasi-experimental study of adult inpatients. Patients were included if they had a documented β-lactam allergy, were interviewed by a pharmacist utilizing a standardized tool, and had the β-lactam allergy updated in the electronic medical record. The primary outcome was the percentage of patients with a complete allergy history documented. A complete allergy history was defined as including a description of the type of reaction, time of the reaction, and timing of the reaction. Secondary endpoints included the documentation of individual allergy history components, including if interventions were required to manage the reaction, tolerance of other β-lactams and receipt of penicillin skin testing in the past. A subgroup analysis was also performed among patients who received antibiotics during the admission evaluating antibiotic use, length of stay, mortality, and readmission. RESULTS: The study included 107 patients. The average time to complete an interview was 14.8 minutes. After the interview, 11 (10%) patients had the β-lactam allergy label removed. Consequently 107 allergy labels were evaluated in the pre-interview arm and 96 allergy labels in the post-interview arm. More patients had a documented complete allergy history after pharmacist intervention (39% vs. 0%, P < 0.001). Documentation of all components of the allergy history improved after the interview (Table 1). Additionally, the amount of patients with an unknown reaction significantly declined (21% vs. 6%, P = 0.004). CONCLUSION: The use of a standardized β-lactam allergy interview tool improved the quality of allergy documentation, led to de-labeling of β-lactam allergies, and reduced the amount of unknown reactions. [Image: see text] DISCLOSURES: All authors: No reported disclosures. |
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