Evidence map›Paper›PMID 39244224›Full record

ArticleBMJ open quality2024

Factors influencing implementation and adoption of direct oral penicillin challenge for allergy delabelling: a qualitative evaluation.

Yogini H Jani, Iestyn Williams, Mairead McErlean, Rashmeet Bhogal, Bee Yean Ng, Kornelija Kildonaviciute, Ariyur Balaji, Ron Daniels, Louise Dunsmure, Chidanand Hullur and 10 more

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In one paragraph

Article in BMJ open quality, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

20 authors.

Yogini H JaniCentre for Medicines Optimisation Resaerch and Education, University College London Hospitals NHS Foundation Trust, London, UK yogini.jani@nhs.net.ORCID http://orcid.org/0000-0001-5927-5429
Iestyn WilliamsHealth Services Management Centre, University of Birmingham, Birmingham, UK.
Mairead McErleanCentre for Medicines Optimisation Resaerch and Education, University College London Hospitals NHS Foundation Trust, London, UK.
Rashmeet BhogalDepartment of Pharmacy, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Bee Yean NgDepartment of Pharmacy, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Kornelija KildonaviciuteDepartment of Pharmacy, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Ariyur BalajiUniversity Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Ron DanielsUK Sepsis Trust, London, UK.
Louise DunsmureDepartment of Pharmacy, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Chidanand HullurDepartment of Anaesthesia, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Nicola JonesDepartment of Infectious Diseases, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Siraj MisbahImmunology, Oxford University Hospitals NHS Trust, Oxford, UK.
Rachel PollardDepartment of Anaesthesia, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
Neil PowellRoyal Cornwall Hospitals NHS Trust Pharmacy Department, Truro, UK.
Jonathan A T SandoeMicrobiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Caroline ThomasLeeds Teaching Hospitals NHS Trust, Leeds, UK.
Amena WarnerAllergy UK, London, UK.
Robert M WestCentre for Epidemiology and Biostatistics, University of Leeds, Leeds, UK.
Louise SavicDepartment of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
Mamidipudi Thirumala KrishnaDepartment of Allergy and Immunology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOver 95% of penicillin allergy labels are inaccurate and may be addressed in low-risk patients using direct oral penicillin challenge (DPC). This study explored the behaviour, attitudes and acceptability of patients, healthcare professionals (HCPs) and managers of using DPC in low-risk patients.

methodsMixed-method, investigation involving patient interviews and staff focus groups at three NHS acute hospitals. Transcripts were coded using inductive and deductive thematic analysis informed by the Theoretical Domains Framework.

findingsAnalysis of 43 patient interviews and three focus groups (28 HCPs: clinicians and managers) highlighted themes of 'knowledge', 'beliefs about capabilities and consequences', 'environmental context', 'resources', 'social influences', 'professional role and identity', 'behavioural regulation and reinforcement' and a cross-cutting theme of digital systems. Overall, study participants supported the DPC intervention. Patients expressed reassurance about being in a monitored, hospital setting. HCPs acknowledged the need for robust governance structures for ensuring clarity of roles and responsibilities and confidence.

conclusionThere were high levels of acceptability among patients and HCPs. HCPs recognised the importance of DPC. Complexities of penicillin allergy (de)labelling were highlighted, and issues of knowledge, risk, governance and workforce were identified as key determinants. These should be considered in future planning and adoption strategies for DPC.

Indexed as

Drug HypersensitivityFocus GroupsPenicillinsQualitative ResearchAdministration, OralAdultAnti-Bacterial AgentsFemaleHumansInterviews as TopicMaleMiddle AgedAnti-Bacterial AgentsPenicillinsAdverse events, epidemiology and detectionAntibiotic managementMedication safetyPatient safety

Identifiers

PMID39244224
PMCPMC11381692

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.