{
  "abstract": "Background and Importance Patients report an allergy to penicillin but few have a confirmed allergy. Many can be de-labelled using a formal assessment by an allergist (high risk of allergy likelihood/severe reaction probability) or non-allergists including clinical pharmacists (low risk of allergy likelihood).Aim and Objectives To evaluate the outcome of penicillin allergy de-labelling on patient allergy status documentation. Objectives were to ascertain the outcome of the de-labelling at point of discharge and to follow-up, identify and understand the current allergy status as documented in the primary care general practice (GP) electronic health record (EHR).Material and Methods Mixed-method evaluation using retrospective EHR review of patients who were de-labelled using oral penicillin challenge by hospital clinical pharmacist and semi-structured interview with GP staff. De-labelled patient list was provided by the de-labelling service team. The documented allergy status was reviewed on the hospital EHR. A follow-up interview was arranged with the GP staff to ascertain allergy status as documented in primary care, and explore workflow, digital system or patient related factors for any disparities between the de-labelling outcome recommendation. Descriptive statistics were used for numbers of patients and change to allergy status; interviews were analysed using inductive thematic analysis.Results Forty patients were de-labelled between March 2022 to November 2024. Six patients were excluded (five died, one record not available). 34 patients‘ hospital EHR were reviewed and showed de-labelling outcomes. In two cases, the patients were noted to request the label remained due to intolerances. Follow-up interviews took place with four GP practices, involving eight patients. The remaining practices indicated not enough time to participate or patient no longer registered. Four out of eight (4/8) patient’s records had no change in allergy status as the practice report no communication received of successful de-labelling; two patients’ allergy status were changed, two records noted the de-labelling outcome but no change was made to allergy status. Key influencing factors were mode of communication (digital interface or electronic letter), prominence of the change, and individual responsibility of updating.Conclusion and Relevance Non-allergist de-labelling by hospital clinical pharmacists was successful but variably sustained in the primary care record. Further policy, communication and education efforts are needed for whole system improvement.Conflict of Interest No conflict of interest",
  "authors": [
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, Centre for Medicines Optimisation Research and Education-Cmore, London, UK",
        "Ucl School of Pharmacy, Research Department of Practice and Policy, London, UK"
      ],
      "name": "Y Jani"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, Centre for Medicines Optimisation Research and Education-Cmore, London, UK"
      ],
      "name": "P Panesar"
    },
    {
      "affiliations": [
        "University College London Hospitals NHS Foundation Trust, Centre for Medicines Optimisation Research and Education-Cmore, London, UK"
      ],
      "name": "E Cooper"
    },
    {
      "affiliations": [
        "University College London and University College London Hospitals NHS Foundation Trust, Infectious Diseases/Microbiology, London, UK"
      ],
      "name": "A Das"
    }
  ],
  "title": "5PSQ-146 Penicillin allergy de-labelling service follow-up evaluation",
  "uid": "63e21cd5-d892-5015-a477-72201b5d51f9"
}