Open AccessAdverse drug reaction classification by health professionals: appropriate discrimination between allergy and intolerance?
Author(s) -
Shakib Sepehr,
Caughey Gillian E.,
Fok Jie Shen,
Smith William B.
Publication year - 2019
Publication title -
clinical and translational allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.979
H-Index - 37
ISSN - 2045-7022
DOI - 10.1186/s13601-019-0259-6
Subject(s) - contraindication , medicine , allergy , adverse drug reaction , drug reaction , health professionals , drug allergy , drug , adverse effect , pediatrics , alternative medicine , immunology , health care , psychiatry , pathology , economics , economic growth
Background The correct classification of an adverse drug reaction (ADR) as allergy (immunological) or intolerance (non‐immunological) has important clinical implications. The aim of this study was to examine the ability of health professionals to discriminate between allergy and intolerance, classify the severity of the ADR and degree of contraindication. Methods Health professionals were presented ten ‘real‐life’ ADR scenarios using an online questionnaire and asked to: categorise the reaction as allergy or intolerance, rate the severity of the reaction and judge the level of contraindication of the causative drug. The number and proportion of responses were calculated for each of the cases presented and associations between classification of reaction type, severity and level of contraindication were examined. Results A total of 394 responses were received. Overall 59.0% (SD 28.9) correctly categorised the cases, 60.8% (SD 16.8) classified the severity correct, and less than half (44.7%, SD 28.6) correctly identified the level of contraindication. The proportion of health professionals correctly answering the type, severity and level of contraindication for the allergy case was significantly higher ( p < 0.0001) by comparison to the intolerance cases (type: 56.6% ± 33.1; severity: 57.3 ± 11.9; level of contraindication: 38.5 ± 19.9). Conclusions Health professionals have suboptimal understanding of classification of ADRs. Strategies are required to strictly avoid re‐exposure of patients to drugs which carry an increased risk of inducing a dangerous reaction, whilst minimising the avoidance of drugs which are of minimal risk or allowing the use of low‐risk drugs where the benefits may be significant.