REPeAL Implementation Study
Research type
Research Study
Full title
Removal of Erroneous Penicillin Allergy Labels: implementation study(REPeAL IS)
IRAS ID
335337
Contact name
Neil Powell
Contact email
Sponsor organisation
Royal Cornwall Hospital Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Fifteen percent of hospitalised patients have a self-reported penicillin allergy (penA) record which means these patients are not prescribed first line penicillin antibiotics, instead receiving second or third line antibiotics which are associated with poorer patient outcomes (e.g. treatment failure and increased mortality) and poorer healthcare
outcomes (e.g. increased length of hospital stay and increased treatment costs). These poorer outcomes are unnecessary because more than 90% of patients with self-reported penicillin allergy records are not allergic to penicillin and can therefore to be prescribed first line penicillin. The literature supports the safety of hospital doctors and pharmacists removing penicillin allergy records and prescribing penicillin to patients with low-risk penicillin
allergy records.National and international guidelines on penA de-labelling will be used, along with the published studies on penicillin allergy de-labelling, to develop hospital-wide guidelines and a toolkit (which includes education for healthcare workers, information leaflets for patients on the risks of having a penicillin allergy label and the risks and benefits of testing, GP letter proformas to facilitate communication between secondary care and primary care, and a risk assessment tool) which aims to facilitate penicillin allergy risk assessment and de-label of adult inpatients as a standard of care and delivered by ward doctors, ward pharmacists and ward nurses.
The penicillin allergy de-labelling patient pathway will be implemented using quality improvement methods and championed by the antimicrobial stewardship team. The study will test the implementation strategy as well as patient and healthcare worker acceptance of the patient pathway and the impact of de-labelling on antibiotic prescribing and patient outcomes. The data will be used to further optimise implementation of the patient pathway.
REC name
North East - Newcastle & North Tyneside 2 Research Ethics Committee
REC reference
23/NE/0231
Date of REC Opinion
15 Jan 2024
REC opinion
Further Information Favourable Opinion