The drug allergy history tool (DAHT): Validation of a patient-reported survey instrument

While the reaction history is critical for drug allergy evaluations and is typically self-reported, there is no validated survey instrument to collect drug allergy history from patients.

We validated a survey instrument that collects patient-reported drug allergy history.

The drug allergy history tool (DAHT) was revised after 3 rounds of cognitive testing, assessed for reliability through test-retest comparisons, and assessed for quality and validity through a concordance analysis against electronic health record allergist documentation. Participants completing testing and surveys had 1 or more drug allergies and were recruited from allergy clinics at Massachusetts General Hospital. Primary evaluative measures were percentage agreement and kappa statistic values.

The DAHT was completed by 79 individuals (mean age, 49 [SD 17] years, 85% female, 85% White, 11% Hispanic ethnicity), 29 with single drug allergy labels and 50 with multiple drug allergy labels. The most common drug allergy labels were penicillins (77%), sulfonamides (32%), cephalosporins (15%), and nonsteroidal anti-inflammatory drugs (8%). The DAHT achieved acceptable test-retest reliability (median κ = 0.64, median agreement = 86%). The DAHT achieved a more complete allergy history than allergist documentation in the electronic health record, with lower median item uncertainty (21% DAHT vs 79% electronic health record) with fair concordance (median κ = 0.21, median agreement = 67%) between the two data sources.

The DAHT is a reliable and valid source of patient-reported drug allergy information. This tool can be used in clinical care and clinical research to obtain standardized patient-reported drug allergy history.