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Adherence with allergen immunotherapy labeling guidelines.

Marilyn Karam1, Kiela Samuels2, Christine Holland1

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The Journal of Allergy and Clinical Immunology. in Practice
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Summary

Adherence to allergen immunotherapy (AIT) labeling guidelines is low, with fewer than 25% of non-university prescribers meeting standards. Complete AIT labels improve clarity for dosing and reaction management.

Keywords:
AdherenceAllergen extractsAllergen immunotherapyHealth services researchImmunotherapy labelingPractice guidelinesPractice parametersStudent health services

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Area of Science:

  • Allergy and Immunology
  • Clinical Pharmacy
  • Patient Safety

Background:

  • Adherence to allergen immunotherapy (AIT) labeling guidelines is not well-documented.
  • Current practice parameters for AIT labeling exist but their implementation is unclear.

Purpose of the Study:

  • To evaluate adherence to the AIT Practice Parameter 2011 labeling guidelines.
  • To assess the completeness of AIT vial labels at the University of Michigan Health Service.

Main Methods:

  • A retrospective review of 320 AIT vials from patients at the University of Michigan Health Service was conducted.
  • Data collected included patient identifiers, concentration (v/v), color coding, allergen content, expiration date, and dosing/treatment instructions.
  • Statistical analysis involved chi-squared tests, Fisher exact tests, and logistic regression.

Main Results:

  • Only 21% of non-university formulated AIT labels met all 5 recommended components, compared to 100% for university-formulated vials.
  • Specific elements like two patient identifiers (PIs) and v/v concentration were associated with more complete labels.
  • Complete AIT labels significantly correlated with clearer instructions for dosing schedules, adjustments, and systemic reaction treatment.

Conclusions:

  • Adherence to AIT labeling guidelines by non-university prescribers was poor, with less than 25% compliance 5 years post-publication.
  • Inclusion of specific identifiers and concentration formats improved the likelihood of complete AIT labels.
  • Complete labeling is associated with enhanced clarity in AIT dosing and emergency treatment protocols.