Tell Me About Your Allergies


Video Presentation


Introduction: A drug allergy history is a useful tool for a clinician when forming an individualized treatment plan and can help to prevent adverse outcomes such as life threatening IgE-mediated allergic reactions. It appears that a patient's history has potential to be a double-edged sword, however, when medications are erroneously charted as an allergy. These medications are subsequently avoided, and a second-line therapy is chosen, possibly with a higher cost or less attractive side effect profile. It is unknown what percentage of reported drug allergies are true allergic reactions, though it is theorized that as many as 90% of antibiotic allergies are documented in error; a falsely high rate of allergies to drugs across all classes may one day be uncovered.

Objectives: It was the goal of this study to explore the validity of patient reporting of drug allergies through reviewing electronic health records and conducting patient interviews.

Methodology: Patients included in this study were selected from the patient lists of a single physicians’ group at one hospital in Kingsport, TN. A review was conducted of patient records, their drug allergies along with specific reactions were noted, then each patient was interviewed regarding their allergies. Patient responses were used to determine if these were true drug allergies, non-allergic adverse reactions, or falsely documented in the record.

Results: Thus far, the medical history of 100 patients has been examined, totaling 217 individual drug allergies. Of these, 84 (38.7%) were found to suggest a true allergic reaction, 114 (52.5%) reflected a non-allergic adverse drug reaction, and 19 (8.8%) were documented in error.

Conclusion: In this study, most charted drug allergies reviewed were not found to be true IgE-mediated allergic reactions. Whether a reported medication allergy is accurate or not, many clinicians may choose to avoid these medications completely. In an effort to improve patient care and broaden the list of medications available for providers to use, we recommend careful and deliberate questioning when obtaining a patient’s history; more medications to choose from can mean cheaper and safer options.