National Institute for Health and Clinical Excellence (NICE)
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Improve recording of drug allergy to reduce risk of reactions

Redesigning prescriptions to include information on drugs or drug classes that patients with known drug allergy should avoid, can reduce the risk of allergic reactions says NICE.

Providing this information could help avoid patients with known allergies wrongly receiving drugs that could endanger their health.

While all drugs can have side effects, some can lead to allergic reactions caused by drug intolerance.

Drugs often responsible for allergic reactions include antibiotics, general anaesthesia, and painkillers such as aspirins and ibuprofen.

In certain cases, the reaction can be severe. Each year around 62,000 people are admitted to hospital after experiencing a serious allergic reaction to a drug. Between 2005 and 2013 there were 18,079 of such incidents, which included 6 deaths, and 19 people who were severely harmed.

There are several reasons why people with drug allergy are currently being prescribed or administered drugs that they are allergic to. These include poor clinical documentation of drug allergy, the lack of patient information on drug allergy, and the lack of a routine system in place for people to keep a record of their own drug allergies.

To tackle this, NICE has published a new guideline on the diagnosis and management of drug allergy in adults, children and young people.

The guideline recommends that when a person presents with suspected drug allergy, their reaction should be documented in a structured approach.

Among the information included should be the generic and proprietary name of the drug or drugs suspected to have caused the reaction including the strength and formulation, a description of the reaction, and the date and time of the reaction.

NICE recommends that paper or electronic prescriptions in any healthcare setting should be standardised and redesigned to record information on which drugs or drug classes to avoid, to reduce the risk of drug allergy.

Clinicians should check a person’s drug allergy status and confirm it with them, or their family members or carers as appropriate, before prescribing, dispensing or administering any drug.

If there is a change in drug allergy status, the patient’s medical records should be updated and their GP should be informed.

In addition, clinicians should discuss the person’s suspected drug allergy with them, and their family members or carers as appropriate, and provide structured written information. They should record who provided the information and when.

They should also ensure that the person and, their family or carers as appropriate, are aware of the drugs or drug classes that they need to avoid.

Elsewhere, the guideline recommends a method for prioritising the thorough assessment of any person who is suspected of having a drug allergy, and details what signs to look out for.

Dr Shuaib Nasser, Consultant Allergist, Addenbrooke’s Hospital, Cambridge and Chair of the Guideline Development Group, said: “Wrongly prescribing drugs to people with known allergies puts them at serious risk of harm but we know this can be avoided. It is important that this is done, as some allergic reactions can be fatal.

“The guideline stresses the care all healthcare professionals must take when documenting new drug allergies and the importance of sharing this information with patients and other healthcare professionals.

“People should be provided with structured written information on drugs to avoid and be advised to check with their pharmacist before taking over-the-counter medicines.”

Professor Mark Baker, Director of the Centre for Clinical Practice at NICE, said: “About half a million people admitted into NHS hospitals each year will have a diagnosed drug allergy. If we know that giving someone a particular drug could cause them harm, or in the worst instances may even kill them, the utmost care must be taken to ensure they are not prescribed or administered that drug.

“This new guideline encourages all healthcare professionals to be alert to the possibility of drug allergies and offers best practice on clinical management to ensure every individual is spared from serious harm.”

For full information on all that NICE has recommended on this topic, visit the NICE Pathway on drug allergy.

 
 
Channel website: https://www.nice.org.uk/

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