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Large Health System Databases and Drug Hypersensitivity.

Anca Mirela Chiriac1, Eric Macy2

  • 1Department of Pulmonology, Division of Allergy, Hôpital Arnaud de Villeneuve, University Hospital of Montpellier, Montpellier, France; UMR-S 1136 INSERM-Sorbonne Université, Equipe EPAR - IPLESP, Paris, France.

The Journal of Allergy and Clinical Immunology. in Practice
|September 10, 2019
PubMed
Summary

Large health databases enhance understanding of drug hypersensitivity and intolerance. Auditing electronic health records is crucial for accurate adverse drug reaction analysis.

Keywords:
Adverse drug reactionAllergyAnaphylaxisAntibioticDatabaseDrugElectronic health recordHypersensitivityIncidenceIntolerancePrevalenceSerious cutaneous adverse reactions

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Area of Science:

  • Pharmacovigilance and Epidemiology
  • Health Informatics

Background:

  • Large health system databases have significantly advanced the study of adverse drug reactions (ADRs) and drug hypersensitivity.
  • Electronic medical record (EMR) systems within integrated health care networks offer comprehensive data on patient interactions.
  • Understanding population-based incidence and risks of ADRs, including delayed reactions and allergy delabeling, is critical.

Purpose of the Study:

  • To highlight the value of large health system databases in understanding drug intolerance and hypersensitivity.
  • To discuss the utility of integrated EMR systems for epidemiological research on ADRs.
  • To identify current limitations and future improvements for utilizing electronic data in ADR research.

Main Methods:

  • Analysis of large health system databases, including electronic medical records.
  • Examination of population-based incidence of adverse drug reactions.
  • Review of risks and benefits associated with drug allergy delabeling.

Main Results:

  • Large databases enable determination of background rates for new drug intolerances.
  • These databases are essential for studying severe and non-severe ADRs, delayed reactions (e.g., Clostridioides difficile), and outcomes of allergy delabeling (e.g., penicillin allergy).
  • Current limitations include miscoding and lack of proven causality in billing data.

Conclusions:

  • Large health system databases are invaluable for pharmacovigilance and understanding drug hypersensitivity.
  • Auditing electronic health records is necessary to ensure accuracy in identifying drug-induced adverse events.
  • Improvements in International Classification of Diseases (ICD) coding for hypersensitivity will further enhance the utility of these databases.