Evidence map›Paper›PMID 39716339›Full record

ArticleAllergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology2024

Developing and disseminating an electronic penicillin allergy de-labelling tool using the model for improvement framework.

Sujen Saravanabavan, Patrick McKernan, Scott Cameron, Natasha Kwan, Kristopher T Kang, Ashley Roberts, Roxane Carr, Raymond Mak, Chelsea Elwood, Vanessa Paquette and 11 more

Abstract read
In one paragraph

Article in Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Review
  2. Review
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

21 authors.

Sujen SaravanabavanBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada. sujen.saravanabavan@gmail.com.
Patrick McKernanFaculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
Scott CameronDivision of Allergy, Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.
Natasha KwanBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Kristopher T KangBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Ashley RobertsBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Roxane CarrBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Raymond MakBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Chelsea ElwoodBC Women's Hospital and Health Centre, Vancouver, BC, Canada.
Vanessa PaquetteBC Women's Hospital and Health Centre, Vancouver, BC, Canada.
Rochelle StimpsonBC Centre for Disease Control, Vancouver, BC, Canada.
Bethina AbrahamsProvincial Health Services Authority, Vancouver, BC, Canada.
Edmond S ChanBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.
Kathryn SlayterIWK Health Centre, Halifax, Halifax, NS, Canada.
Alicia RahierUniversity Hospital of Northern British Columbia, Prince George, BC, Canada.
Irina SainchukUniversity Hospital of Northern British Columbia, Prince George, BC, Canada.
Sharla OlsenUniversity Hospital of Northern British Columbia, Prince George, BC, Canada.
Melissa KuceyRegina General Hospital, Regina, SK, Canada.
Jinan ShamseddineDepartment of Pharmacy, Sheikh Shakhbout Medical City, PO Box 11001, Abu Dhabi, United Arab Emirates.
Zahir Osman Eltahir BabikerTropical and Infectious Diseases Division, Sheikh Shakhbout Medical City, PO Box 11001, Abu Dhabi, United Arab Emirates.ORCID https://orcid.org/0000-0002-6129-4597
Tiffany WongBC Children's Hospital, 4480 Oak Street, Room 1C31B, Oak Street Entrance, 1982 Building, Djavid Mowafaghian Wing, Vancouver, BC, V6H 3V4, Canada.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMany clinicians feel uncomfortable with de-labelling penicillin allergies despite ample safety data. Point of care tools effectively support providers with de-labelling. This study's objective was to increase the number of providers intending to pursue a penicillin oral challenge by 15% by February 2023.

methodsA validated de-labelling algorithm was translated into an electronic point of care tool and disseminated to eight healthcare institutions. Applying the Model for Improvement Framework, three PDSA cycles were conducted, where collected data and completed surveys were analysed to implement changes. Number of providers intending to pursue an oral challenge, tool usage as well as number of clinicians who felt satisfied with the tool and felt confident in its ability to risk-stratify patients was collected.

results50.4% of providers intended to give an oral challenge of penicillin with version 1, which improved to 65.5% with version 2, representing a 15.1% increase. With version 1 of the tool, there was an average of 61.3 counts of tool usage per month. 73.1% of providers felt satisfied with the tool and 76.9% felt confident in its ability to risk-stratify patients. With version 2 of the tool, after implementing changes through three PDSA cycles, monthly usage counts increased to an average of 98.6. Furthermore, 100.0% of providers felt satisfied with the tool and 98.1% felt confident with the tool's ability to risk-stratify patients.

conclusionOur quality improvement approach demonstrated improvement in the percentage of providers that intended to pursue an oral challenge and felt satisfied and confident in the risk-stratification capabilities of penicillin allergy de-labelling tool. Electronic tools should be further incorporated into institutional penicillin de-labelling protocols.

Indexed as

Antibiotic allergyClinicalDecision support systemsDrug hypersensitivityPatient safetyPenicillin allergyPenicillin hypersensitivityQuality improvement

Identifiers

PMID39716339
PMCPMC11668003

What OpenQuestion holds

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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.