Kimberly G Blumenthal1, Erica S Shenoy2, Shelley Hurwitz3, Christy A Varughese4, David C Hooper5, Aleena Banerji6. 1. Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Mass. Electronic address: kblumenthal1@partners.org. 2. Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, Mass; Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Infection Control Unit, Massachusetts General Hospital, Boston, Mass. 3. Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass. 4. Infection Control Unit, Massachusetts General Hospital, Boston, Mass; Department of Pharmacy, Massachusetts General Hospital, Boston, Mass. 5. Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass; Infection Control Unit, Massachusetts General Hospital, Boston, Mass. 6. Division of Rheumatology, Allergy, and Immunology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Mass.
Abstract
BACKGROUND: Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. OBJECTIVES: Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. METHODS: We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporin allergy. RESULTS: Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P < .001) and loss of PCN allergy over time (54% vs 80%; P < .0001). Among those who reported attending an educational session (n = 62), preparedness to determine if an allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. CONCLUSIONS: Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools.
BACKGROUND: Inpatient providers have varying levels of knowledge in managing patients with drug and/or penicillin (PCN) allergy. OBJECTIVES: Our objectives were (1) to survey inpatient providers to ascertain their baseline drug allergy knowledge and preparedness in caring for patients with PCN allergy, and (2) to assess the impact of an educational program paired with the implementation of a hospital-based clinical guideline. METHODS: We electronically surveyed 521 inpatient providers at a tertiary care medical center at baseline and again 6 weeks after an educational initiative paired with clinical guideline implementation. The guideline informed providers on drug allergy history taking and antibiotic prescribing for inpatients with PCN or cephalosporinallergy. RESULTS: Of 323 unique responders, 42% (95% CI, 37-48%) reported no prior education in drug allergy. When considering those who responded to both surveys (n = 213), we observed a significant increase in knowledge about PCN skin testing (35% vs 54%; P < .001) and loss of PCN allergy over time (54% vs 80%; P < .0001). Among those who reported attending an educational session (n = 62), preparedness to determine if an allergy was severe significantly improved (77% vs 92%; P = .03). Other areas, including understanding absolute contraindications to receiving a drug again and PCN cross-reactivity with other antimicrobials, did not improve significantly. CONCLUSIONS: Inpatient providers have drug allergy knowledge deficits but are interested in tools to help them care for inpatients with drug allergies. Our educational initiative and hospital guideline implementation were associated with increased PCN allergy knowledge in several crucial areas. To improve care of inpatients with drug allergy, more research is needed to evaluate hospital policies and sustainable educational tools.
Authors: P A Gross; S Greenfield; S Cretin; J Ferguson; J Grimshaw; R Grol; N Klazinga; W Lorenz; G S Meyer; C Riccobono; S C Schoenbaum; P Schyve; C Shaw Journal: Med Care Date: 2001-08 Impact factor: 2.983
Authors: Anca M Chiriac; Aleena Banerji; Rebecca S Gruchalla; Bernard Y H Thong; Paige Wickner; Paul-Michel Mertes; Ingrid Terreehorst; Kimberly G Blumenthal Journal: J Allergy Clin Immunol Pract Date: 2018-12-17
Authors: Kimberly G Blumenthal; Erin E Ryan; Yu Li; Hang Lee; James L Kuhlen; Erica S Shenoy Journal: Clin Infect Dis Date: 2018-01-18 Impact factor: 9.079
Authors: Jason A Trubiano; Cosby A Stone; M Lindsay Grayson; Karen Urbancic; Monica A Slavin; Karin A Thursky; Elizabeth J Phillips Journal: J Allergy Clin Immunol Pract Date: 2017-08-23
Authors: Kimberly G Blumenthal; Erica S Shenoy; Anna R Wolfson; David N Berkowitz; Victoria A Carballo; Diana S Balekian; Kathleen A Marquis; Ramy Elshaboury; Ronak G Gandhi; Praveen Meka; David W Kubiak; Jennifer Catella; Barbara B Lambl; Joyce T Hsu; Monique M Freeley; Alana Gruszecki; Paige G Wickner Journal: J Allergy Clin Immunol Pract Date: 2017 May - Jun
Authors: Rashmeet Bhogal; Abid Hussain; Ariyur Balaji; William H Bermingham; John F Marriott; Mamidipudi T Krishna Journal: Int J Clin Pharm Date: 2021-01-13
Authors: Foster R Goss; Kenneth H Lai; Maxim Topaz; Warren W Acker; Leigh Kowalski; Joseph M Plasek; Kimberly G Blumenthal; Diane L Seger; Sarah P Slight; Kin Wah Fung; Frank Y Chang; David W Bates; Li Zhou Journal: J Am Med Inform Assoc Date: 2018-06-01 Impact factor: 4.497
Authors: Cosby A Stone; Jason Trubiano; David T Coleman; Christine R F Rukasin; Elizabeth J Phillips Journal: Allergy Date: 2019-05-26 Impact factor: 13.146