Disparity in Patients' Medication Allergy Information
Disparity in Patients' Medication Allergy Information
A total of 101 patients were interviewed during the 4-month period and there were 235 drug allergies. Each allergy either was recorded in the chart or stated during the interview. To be included in the study, each patient had to have at least one allergy recorded in his or her chart. Demographic characteristics are described in Table 1. The population was predominantly white women with a mean age of 51 years.
The median number of allergies per patient was two for women (interquartile range 1–3) and 1 for males (interquartile range 1–2). The most common class of medication that was responsible for allergies was antibiotics. A total of 80 (34%) medications consisted of penicillins (35, 14.9%), sulfas (21, 8.9%), and all other aggregated antibiotics (24, 10.2%). The next highest offending class was opiate analgesics (61, 26%). Each of the 101 patients had at least one allergy to a drug noted in the chart, and more may have been discovered during the interview. Some charts documented the allergy but not the type of reaction. The 235 listed allergies represent the drugs for which the chart and/or interviewer found an allergy to that drug. The comparison between the chart and the interview regarding allergies is shown in Table 2. Table 3 shows the results of a subgroup analysis broken down by the type of allergic reaction documented in the chart or obtained during the interview.
Upon interviewing the patients, 18 (7.7%) allergies were discovered that were not in the chart. In addition, a different 18 (7.7%) allergies documented in the chart were denied by patients upon interview. Some of reaction descriptors were omitted in the patients' charts, and approximately 32% of the allergies had no reaction descriptor specified. The percentage of agreement for reaction descriptors between previously documented allergies and patient interviews was 50%. Total profile agreement for allergy information occurred in only nine patients. When checking for general agreement on an allergy, the two sources (chart vs interviews) were in agreement 85% of the time (Table 2). When we tried to determine the type of reaction, the agreement between the chart and the interview dropped to 50%, however (Table 3).
Results
A total of 101 patients were interviewed during the 4-month period and there were 235 drug allergies. Each allergy either was recorded in the chart or stated during the interview. To be included in the study, each patient had to have at least one allergy recorded in his or her chart. Demographic characteristics are described in Table 1. The population was predominantly white women with a mean age of 51 years.
The median number of allergies per patient was two for women (interquartile range 1–3) and 1 for males (interquartile range 1–2). The most common class of medication that was responsible for allergies was antibiotics. A total of 80 (34%) medications consisted of penicillins (35, 14.9%), sulfas (21, 8.9%), and all other aggregated antibiotics (24, 10.2%). The next highest offending class was opiate analgesics (61, 26%). Each of the 101 patients had at least one allergy to a drug noted in the chart, and more may have been discovered during the interview. Some charts documented the allergy but not the type of reaction. The 235 listed allergies represent the drugs for which the chart and/or interviewer found an allergy to that drug. The comparison between the chart and the interview regarding allergies is shown in Table 2. Table 3 shows the results of a subgroup analysis broken down by the type of allergic reaction documented in the chart or obtained during the interview.
Upon interviewing the patients, 18 (7.7%) allergies were discovered that were not in the chart. In addition, a different 18 (7.7%) allergies documented in the chart were denied by patients upon interview. Some of reaction descriptors were omitted in the patients' charts, and approximately 32% of the allergies had no reaction descriptor specified. The percentage of agreement for reaction descriptors between previously documented allergies and patient interviews was 50%. Total profile agreement for allergy information occurred in only nine patients. When checking for general agreement on an allergy, the two sources (chart vs interviews) were in agreement 85% of the time (Table 2). When we tried to determine the type of reaction, the agreement between the chart and the interview dropped to 50%, however (Table 3).
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