Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI)
Background: Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have...
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Elsevier
2024-12-01
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| Series: | World Allergy Organization Journal |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1939455124001352 |
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| author | James K.Y. Hooi, MBChB Marshall C.H. Low, BPharm Jonathan C.L. To, BPharm Hugo W.F. Mak, MBBS Mandy M. Choi, BPharm Chris C.P. Tam, BPharm Raymond W.M. Mak, MSc Vincent K.C. Wong, MPharm Timo C.C. Chan, MClinPharm Andrew W.T. Li, MClinPharm Charlie C.Y. Mak, MClinPharm Valerie Chiang, MBBS Gordon K.H. Chu, MBBS Jane C.Y. Wong, MBBS Philip H. Li, MD |
| author_facet | James K.Y. Hooi, MBChB Marshall C.H. Low, BPharm Jonathan C.L. To, BPharm Hugo W.F. Mak, MBBS Mandy M. Choi, BPharm Chris C.P. Tam, BPharm Raymond W.M. Mak, MSc Vincent K.C. Wong, MPharm Timo C.C. Chan, MClinPharm Andrew W.T. Li, MClinPharm Charlie C.Y. Mak, MClinPharm Valerie Chiang, MBBS Gordon K.H. Chu, MBBS Jane C.Y. Wong, MBBS Philip H. Li, MD |
| author_sort | James K.Y. Hooi, MBChB |
| collection | DOAJ |
| description | Background: Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have been advocated. However, evidence of their effectiveness, safety and impact on health-related quality-of-life (HR-QoL) are lacking.To assess and compare the effectiveness, safety and improvements on HR-QoL of pharmacists vs allergists in a pilot low-risk penicillin allergy delabelling initiative. Methods: All adult patients referred for low-risk penicillin allergy were randomized and evaluated by either pharmacists or allergists in a 1:3 ratio. Outcomes and changes in Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) scores were compared. Results: Of 323 patients referred, 96.3% (311/323) completed penicillin allergy evaluation (pharmacists: 83 [24.3%] vs allergists: 228 [66.7%]). Overall, 93.6% (291/311) were delabelled with no difference between evaluations by pharmacists and allergists (92.8% vs 93.9%, p = 0.729). There were no severe or systemic reactions in either cohort. Patients evaluated by either pharmacists (43.4 [SD:29.1] to 10.5 [SD:5.93], p < 0.001) or allergists (37.2 [SD:22.2] to 29.1 [SD:22.4], p < 0.001) reported improved HR-QoL as reflected by DrHy-Q scores. However, absolute changes in DrHy-Q scores were significantly greater among patients evaluated by pharmacists compared to those by allergists (−24.6 [SD:25.1] vs −9.19 [SD:13.7], p < 0.001). Conclusions: Evaluations and delabelling by pharmacists (vs allergists) were comparably effective and safe among patients with low-risk penicillin allergy. Moreover, patients evaluated by pharmacists even reported significantly greater improvements in HR-QoL, highlighting the potential of multidisciplinary allergy initiatives. |
| format | Article |
| id | doaj-art-40564bcbb38e46ba9601042f9976b105 |
| institution | DOAJ |
| issn | 1939-4551 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | World Allergy Organization Journal |
| spelling | doaj-art-40564bcbb38e46ba9601042f9976b1052025-08-20T02:49:56ZengElsevierWorld Allergy Organization Journal1939-45512024-12-01171210100310.1016/j.waojou.2024.101003Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI)James K.Y. Hooi, MBChB0Marshall C.H. Low, BPharm1Jonathan C.L. To, BPharm2Hugo W.F. Mak, MBBS3Mandy M. Choi, BPharm4Chris C.P. Tam, BPharm5Raymond W.M. Mak, MSc6Vincent K.C. Wong, MPharm7Timo C.C. Chan, MClinPharm8Andrew W.T. Li, MClinPharm9Charlie C.Y. Mak, MClinPharm10Valerie Chiang, MBBS11Gordon K.H. Chu, MBBS12Jane C.Y. Wong, MBBS13Philip H. Li, MD14Division of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Pharmacy and Pharmacology, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Pharmacy and Pharmacology, The University of Hong Kong, Hong Kong SAR, ChinaDivision of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Pharmacy and Pharmacology, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Pharmacy and Pharmacology, The University of Hong Kong, Hong Kong SAR, ChinaDepartment of Pharmacy, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Pharmacy, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Pharmacy, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Pharmacy, Queen Mary Hospital, Hong Kong SAR, ChinaDepartment of Pharmacy, Queen Mary Hospital, Hong Kong SAR, ChinaDivision of Clinical Immunology, Department of Pathology, Queen Mary Hospital, Hong Kong SAR, ChinaDivision of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaDivision of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, ChinaDivision of Rheumatology and Clinical Immunology, Department of Medicine, Queen Mary Hospital, The University of Hong Kong, Hong Kong SAR, China; Corresponding author. Department of Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong SAR, China.Background: Mislabelled penicillin allergies are associated with a myriad of adverse outcomes and development of anti-microbial resistance. With the overwhelming need for specialist allergy services, pharmacist initiatives such as the Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) have been advocated. However, evidence of their effectiveness, safety and impact on health-related quality-of-life (HR-QoL) are lacking.To assess and compare the effectiveness, safety and improvements on HR-QoL of pharmacists vs allergists in a pilot low-risk penicillin allergy delabelling initiative. Methods: All adult patients referred for low-risk penicillin allergy were randomized and evaluated by either pharmacists or allergists in a 1:3 ratio. Outcomes and changes in Drug Hypersensitivity Quality of Life Questionnaire (DrHy-Q) scores were compared. Results: Of 323 patients referred, 96.3% (311/323) completed penicillin allergy evaluation (pharmacists: 83 [24.3%] vs allergists: 228 [66.7%]). Overall, 93.6% (291/311) were delabelled with no difference between evaluations by pharmacists and allergists (92.8% vs 93.9%, p = 0.729). There were no severe or systemic reactions in either cohort. Patients evaluated by either pharmacists (43.4 [SD:29.1] to 10.5 [SD:5.93], p < 0.001) or allergists (37.2 [SD:22.2] to 29.1 [SD:22.4], p < 0.001) reported improved HR-QoL as reflected by DrHy-Q scores. However, absolute changes in DrHy-Q scores were significantly greater among patients evaluated by pharmacists compared to those by allergists (−24.6 [SD:25.1] vs −9.19 [SD:13.7], p < 0.001). Conclusions: Evaluations and delabelling by pharmacists (vs allergists) were comparably effective and safe among patients with low-risk penicillin allergy. Moreover, patients evaluated by pharmacists even reported significantly greater improvements in HR-QoL, highlighting the potential of multidisciplinary allergy initiatives.http://www.sciencedirect.com/science/article/pii/S1939455124001352HypersensitivityDelabellingLow-riskPenicillinsPharmacists |
| spellingShingle | James K.Y. Hooi, MBChB Marshall C.H. Low, BPharm Jonathan C.L. To, BPharm Hugo W.F. Mak, MBBS Mandy M. Choi, BPharm Chris C.P. Tam, BPharm Raymond W.M. Mak, MSc Vincent K.C. Wong, MPharm Timo C.C. Chan, MClinPharm Andrew W.T. Li, MClinPharm Charlie C.Y. Mak, MClinPharm Valerie Chiang, MBBS Gordon K.H. Chu, MBBS Jane C.Y. Wong, MBBS Philip H. Li, MD Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) World Allergy Organization Journal Hypersensitivity Delabelling Low-risk Penicillins Pharmacists |
| title | Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) |
| title_full | Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) |
| title_fullStr | Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) |
| title_full_unstemmed | Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) |
| title_short | Comparing pharmacists versus allergists in low-risk penicillin allergy delabelling: The Hong Kong Penicillin Allergy Pharmacist Initiative (HK-PAPI) |
| title_sort | comparing pharmacists versus allergists in low risk penicillin allergy delabelling the hong kong penicillin allergy pharmacist initiative hk papi |
| topic | Hypersensitivity Delabelling Low-risk Penicillins Pharmacists |
| url | http://www.sciencedirect.com/science/article/pii/S1939455124001352 |
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