Implementation of a Pharmacist-Led Penicillin Allergy Interview at a Veterans Care Facility

Evaluating a patient's β-lactam allergy involves a thorough review of electronic health records (EHRs), penicillin skin test, and observed oral challenge. The purpose of this study was to evaluate the impact of pharmacist-led penicillin allergy delabeling solely through an interview using the Allergy to β-Lactam Evaluation (ABLE) process.

This single-facility, retrospective cohort study reviewed EHR notes. Patient eligibility for allergy profile modifications was determined using guidance from the ABLE process. Interviews were conducted with patients meeting inclusion criteria. A progress note was entered into the EHR following completion of the interview. Patients were compared to a historical control group and matched for allergy severity (immunoglobulin E [IgE]-mediated allergy, unknown, adverse drug reaction [ADR], and severe cutaneous or other non-IgE-mediated reaction). The primary outcome was the number of patient allergy ADRs that were removed or changed on their profile.

Six of 35 patients in the interviewed group had allergy profile modifications. The number of patients with a penicillin allergy/ADR modified regardless of change in their antibiotic regimen was statistically higher in the interviewed group compared with the control group: 6 (17.1%) vs 0 (0%) (P < .03).

The study findings support the use of the ABLE process for penicillin allergy/ADR modification or clarification. Although the sample size was small, the ABLE process has the ability to positively impact individuals with inappropriate penicillin allergy documentation in the EHR.