• 26Sep

    Better information needed on prescriptions and for patients with drug allergy

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

    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.

    NICE found 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.

    In publishing the new guideline, NICE state that redesigning prescriptions to include information on drugs or drug classes that patients with known drug allergy should avoid, could reduce the risk of allergic reactions. Providing this information could help avoid patients with known allergies wrongly receiving drugs that could endanger their health.

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

    NICE has produced an algorithm to help put this guidance into practice. For full information on all that NICE has recommended on this topic, visit the NICE Pathway on drug allergy.