Resource utilization and cost assessment of a proactive penicillin allergy de-labeling program for low-risk inpatients.
Allergy Asthma Clin Immunol
; 20(1): 7, 2024 Jan 22.
Article
em En
| MEDLINE
| ID: mdl-38254221
ABSTRACT
BACKGROUND:
Resource utilization and costs can impede proactive assessment and de-labeling of penicillin allergy among inpatients.METHODS:
Our pilot intervention was a proactive penicillin allergy de-labeling program for new inpatients with penicillin allergy. Patients deemed appropriate for a challenge with a low-risk penicillin allergy history were administered 250 mg amoxicillin and monitored for 1 h. We performed an explorative economic evaluation using various healthcare professional wages.RESULTS:
Over two separate 2-week periods between April 2021 and March 2022, we screened 126 new inpatients with a penicillin allergy. After exclusions, 55 were appropriate for formal assessment. 19 completed the oral challenge, and 12 were directly de-labeled, resulting in a number needed to screen of 4 and a number needed to assess of 1.8 to effectively de-label one patient. The assessor's median time in the hospital per day de-labeling was 4h08 with a range of (0h05, 6h45). A single-site annual implementation would result in 715 penicillin allergy assessments with 403 patients de-labeled assuming 20,234 annual weekday admissions and an 8.9% penicillin allergy rate. Depending on the assessor used, the annual cost of administration would be between $21,476 ($53.29 per effectively de-labeled patient) for a pharmacy technician and $61,121 ($151.67 per effectively de-labeled patient) for a Nurse Practitioner or Physician Assistant.CONCLUSION:
A proactive approach, including a direct oral challenge for low-risk in-patients with penicillin allergy, appears safe and feasible. Similar programs could be implemented at other institutions across Canada to increase access to allergy assessment.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
14_ODS3_health_workforce
/
1_ASSA2030
Problema de saúde:
14_implementation_strategies_healthcare_workers
/
1_financiamento_saude
/
1_recursos_humanos_saude
Tipo de estudo:
Etiology_studies
/
Health_economic_evaluation
/
Risk_factors_studies
Aspecto:
Implementation_research
Idioma:
En
Revista:
Allergy Asthma Clin Immunol
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Canadá