Enablers and barriers to inpatient penicillin allergy de-labelling
Research type
Research Study
Full title
Removing Erroneous Penicillin Allergy Labels (REPeAL) Work package 2 (WP2) - Qualitative study
IRAS ID
304979
Contact name
Neil Powell
Contact email
Sponsor organisation
Royal Cornwall Hospital NHS Trust
Duration of Study in the UK
1 years, 0 months, 0 days
Research summary
Fifteen percent of hospital patients have a self-reported penicillin allergy record which means these patients are not prescribed first line penicillin antibiotics, instead receiving second or third line antibiotics which are associated with many 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 are able therefore to be prescribed first line penicillin. Identifying these patients has traditionally been the role of allergists using resource intense testing methods but more recently quicker testing methods, undertaken by hospital doctors and pharmacists, have been shown to safely remove about 50% of penicillin allergy records and enable the safely prescribe penicillin. In order to realise the patient benefit of penicillin allergy de-labelling we need to embed penicillin allergy assessment and de-label as part of standard of care for patients admitted to hospital. To enable this we need to explore what hospital healthcare workers (doctors, nurses and pharmacists) and what patients perceive to important in enabling this to happen (enablers) and also to identify anything that we can change that might prevent this from happening (barriers). I will carry out interviews, lasting approximately 45 minutes, with 24 Royal Cornwall Hospital healthcare workers and focus group discussions lasting an hour with 15 patients with penicillin allergy records to explore what those barriers and enablers might be, and then use that information to design an intervention that will embed penicillin allergy assessment and de-label as standard of care for patients thereby reducing the unintended harms to patients and hospitals associated with using non-penicillin antibiotics.
REC name
North West - Liverpool Central Research Ethics Committee
REC reference
21/NW/0317
Date of REC Opinion
1 Nov 2021
REC opinion
Further Information Favourable Opinion