Patient and Primary Care Physician Perceptions of Penicillin Allergy Testing and Subsequent Use of Penicillin-Containing Antibiotics: A Qualitative Study
Removal of an inaccurate penicillin allergy record following testing allows patients to access first-line treatment for infections, and reduce the use of broad-spectrum antibiotics, which contribute to antibiotic resistance. However, it is seldom undertaken. To identify clinicians' working in p...
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Published in | The journal of allergy and clinical immunology in practice (Cambridge, MA) Vol. 7; no. 6; p. 1888 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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United States
01.07.2019
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Abstract | Removal of an inaccurate penicillin allergy record following testing allows patients to access first-line treatment for infections, and reduce the use of broad-spectrum antibiotics, which contribute to antibiotic resistance. However, it is seldom undertaken.
To identify clinicians' working in primary care and patients' views on barriers and enablers for penicillin allergy testing and subsequent antibiotic use.
Fifty interviews with patients and clinicians, including 31 patients with a record of penicillin allergy, 16 with experience of testing, and 19 clinicians. Interviews were analyzed thematically.
Patients were often unaware of the benefits of penicillin allergy testing and only those patients who had experienced negative consequences of having a penicillin allergy label were motivated to get tested. Clinicians were reluctant to change patient records on the basis of their clinical judgment alone but had limited experience of referring patients with suspected penicillin allergy and were often uncertain about referral criteria and what the testing involved. Clinicians felt that allergy testing could be beneficial and patients who had attended testing reported benefits of the test. Clinicians expressed uncertainty related to whose responsibility it was to make sure that the patient understood allergy test results.
Clinicians would benefit from information about penicillin allergy testing to be able to use these services appropriately, and to discuss referral with patients. Patients might be more motivated to seek testing if they were more informed regarding its benefits. Good communication between primary and secondary care would facilitate the updating of medical records, and promote better patient education. |
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AbstractList | Removal of an inaccurate penicillin allergy record following testing allows patients to access first-line treatment for infections, and reduce the use of broad-spectrum antibiotics, which contribute to antibiotic resistance. However, it is seldom undertaken.
To identify clinicians' working in primary care and patients' views on barriers and enablers for penicillin allergy testing and subsequent antibiotic use.
Fifty interviews with patients and clinicians, including 31 patients with a record of penicillin allergy, 16 with experience of testing, and 19 clinicians. Interviews were analyzed thematically.
Patients were often unaware of the benefits of penicillin allergy testing and only those patients who had experienced negative consequences of having a penicillin allergy label were motivated to get tested. Clinicians were reluctant to change patient records on the basis of their clinical judgment alone but had limited experience of referring patients with suspected penicillin allergy and were often uncertain about referral criteria and what the testing involved. Clinicians felt that allergy testing could be beneficial and patients who had attended testing reported benefits of the test. Clinicians expressed uncertainty related to whose responsibility it was to make sure that the patient understood allergy test results.
Clinicians would benefit from information about penicillin allergy testing to be able to use these services appropriately, and to discuss referral with patients. Patients might be more motivated to seek testing if they were more informed regarding its benefits. Good communication between primary and secondary care would facilitate the updating of medical records, and promote better patient education. |
Author | Savic, Sinisa Butler, Christopher C Wanat, Marta Savic, Louise Tonkin-Crine, Sarah Pavitt, Sue H Sandoe, Jonathan A T Anthierens, Sibyl |
Author_xml | – sequence: 1 givenname: Marta surname: Wanat fullname: Wanat, Marta email: marta.wanat@phc.ox.ac.uk organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom. Electronic address: marta.wanat@phc.ox.ac.uk – sequence: 2 givenname: Sibyl surname: Anthierens fullname: Anthierens, Sibyl organization: Department of Primary and Interdisciplinary Care, University of Antwerp, Antwerp, Belgium – sequence: 3 givenname: Christopher C surname: Butler fullname: Butler, Christopher C organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom – sequence: 4 givenname: Louise surname: Savic fullname: Savic, Louise organization: Department of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom – sequence: 5 givenname: Sinisa surname: Savic fullname: Savic, Sinisa organization: Department of Clinical Immunology and Allergy, Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom – sequence: 6 givenname: Sue H surname: Pavitt fullname: Pavitt, Sue H organization: Dental Translational and Clinical Research Unit, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom – sequence: 7 givenname: Jonathan A T surname: Sandoe fullname: Sandoe, Jonathan A T organization: Healthcare Associated Infection Group, University of Leeds and Leeds Teaching Hospitals NHS Trust, Leeds, United Kingdom – sequence: 8 givenname: Sarah surname: Tonkin-Crine fullname: Tonkin-Crine, Sarah organization: Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Observatory Quarter, Oxford, United Kingdom; NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, University of Oxford, Oxford, United Kingdom |
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Copyright | Copyright © 2019 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved. |
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Keywords | Prescribing Antibiotic stewardship Qualitative Penicillin allergy Antibiotic resistance |
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SubjectTerms | Adult Aged Anti-Bacterial Agents - adverse effects Attitude of Health Personnel Attitude to Health Drug Hypersensitivity - diagnosis Female Humans Male Middle Aged Penicillins - adverse effects Perception Physicians, Primary Care - psychology Qualitative Research Skin Tests Young Adult |
Title | Patient and Primary Care Physician Perceptions of Penicillin Allergy Testing and Subsequent Use of Penicillin-Containing Antibiotics: A Qualitative Study |
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