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Patient-related factors drive high rates of reported antibiotic allergies: a qualitative study
  • Renee Berry,
  • Susan Herrmann,
  • Michaela Lucas
Renee Berry
Sir Charles Gairdner Hospital
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Susan Herrmann
University of Western Australia
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Michaela Lucas
Sir Charles Gairdner Hospital

Corresponding Author:[email protected]

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Abstract

Background Unnecessary antibiotic avoidance due to allergy fears has adverse cost and health implications however, the problem is difficult to resolve because patient and provider-related factors leading to avoidance are multifactorial. The perspectives of patients can be explored using qualitative research methods to reach the heart of the problem. Objective To reveal factors leading patients to report antibiotic allergy, and determine what education is required to prevent the cycle of erroneous allergy reporting. Methods The 29 patients were a sample of convenience recruited from a tertiary public hospital in Western Australia; 18 were inpatients and 11 outpatients, with a median age of 64.2 years, and 15 (55%) were female. Semi-structured interviews assessed patients’ understanding and knowledge of three topics: (1) antibiotic allergy, (2) antibiotic allergy testing, and (3) outcomes of testing. Interview transcripts underwent thematic analysis by two researchers, independently. Results Three overlapping themes emerged as influential across topics: (1) Severity of the Index Reaction, (2) Trust in family and health care providers, and (3) Health literacy. Patients were largely unaware of the benefits of confirmatory testing, and the detrimental health consequences of unnecessary avoidance. Patients displayed trust in health care providers’ expertise, and assumed that medical records were accurate to prevent prescribing errors. Conclusions The findings provide evidence for an effective patient education strategy, and highlight failures among hospital and primary health providers to recognise the potential harm of unverified antibiotic allergy. Healthcare professionals are influential at multiple steps of a patient’s healthcare journey and addressing unconfirmed antibiotic allergy should be taken at each opportunity.