Min-Suk Yang1, Sang-Il Choi2, Woo-Jung Song3, Sae-Hoon Kim4, Hye-Ryun Kang3, Heung-Woo Park3, Sang-Heon Cho3, Kyung-Up Min3, Jae-Hyoung Kim2, Yoon-Seok Chang4. 1. Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. 2. Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea. 3. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. 4. Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Abstract
OBJECTIVE: To evaluate the impact of an electronic consultation support system on the incidence of hypersensitivity reactions to iodinated radiocontrast media (RCM). MATERIALS AND METHODS: A retrospective observational study was conducted before and after the introduction of the consultation support system. The 1-year study period was divided into two 6-month periods: before and after 1 December 2012 (baseline and intervention periods, respectively), which was when our consultation support system was introduced. Data from examinations were collected retrospectively from the hospital information centre and problem reporting sheets in the radiology department. The primary outcome was the incidence of RCM reactions before and after the introduction of the consultation support system. Generalised estimating equations were used to account for the correlation between the same patients measured on multiple occasions. RESULTS: There were 317/20,179 (1.6%) and 186/19,873 (0.9%) hypersensitivity reactions during the baseline and intervention periods, respectively. The consultation support system significantly decreased the odds of the occurrence of a RCM reaction (OR=0.59, 95% CI 0.49 to 0.71, p<0.001) compared with baseline. There was also a twofold increase in the premedication rate after initiation of the consultation support system (OR=2.05, 95% CI 1.16 to 3.65 p=0.01). However, there was no significant difference in the recurrence rate between the periods (OR=0.97, 95% CI 0.58 to 1.65, p<0.93). CONCLUSIONS: The introduction of the consultation support system reduced the incidence of hypersensitivity reactions to RCM and increased the use of premedication in patients with known hypersensitivity to RCM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
OBJECTIVE: To evaluate the impact of an electronic consultation support system on the incidence of hypersensitivity reactions to iodinated radiocontrast media (RCM). MATERIALS AND METHODS: A retrospective observational study was conducted before and after the introduction of the consultation support system. The 1-year study period was divided into two 6-month periods: before and after 1 December 2012 (baseline and intervention periods, respectively), which was when our consultation support system was introduced. Data from examinations were collected retrospectively from the hospital information centre and problem reporting sheets in the radiology department. The primary outcome was the incidence of RCM reactions before and after the introduction of the consultation support system. Generalised estimating equations were used to account for the correlation between the same patients measured on multiple occasions. RESULTS: There were 317/20,179 (1.6%) and 186/19,873 (0.9%) hypersensitivity reactions during the baseline and intervention periods, respectively. The consultation support system significantly decreased the odds of the occurrence of a RCM reaction (OR=0.59, 95% CI 0.49 to 0.71, p<0.001) compared with baseline. There was also a twofold increase in the premedication rate after initiation of the consultation support system (OR=2.05, 95% CI 1.16 to 3.65 p=0.01). However, there was no significant difference in the recurrence rate between the periods (OR=0.97, 95% CI 0.58 to 1.65, p<0.93). CONCLUSIONS: The introduction of the consultation support system reduced the incidence of hypersensitivity reactions to RCM and increased the use of premedication in patients with known hypersensitivity to RCM. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.