Management for improving patients’ knowledge and understanding about drug allergy

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Narumol Jarernsiripornkul
Nataporn Chaipichit
Pansu Chumworathayi
Janet Krska


Drug Hypersensitivity, Patient Medication Knowledge, Patient Education as Topic, Pharmaceutical Services, Thailand


Background: Drug allergy a serious adverse drug reaction commonly concerned in healthcare practice. Inadequate documentation and communication between health providers, and limited health literacy and knowledge in patients could contribute to the re-occurrence of allergic reactions.

Objective: To evaluate the effectiveness of initiatives aiming to improve patients’ knowledge, understanding and behavior in preventing recurrent drug allergy.

Methods: A before-and-after study was conducted at an 800-bed university teaching hospital, involving patients with a history of drug allergy. Questionnaires, completed at baseline and one month after receiving information were used to compare knowledge and understanding of drug allergy and behaviors in relation to drug allergy cards. Patients in Group 1 received a brochure only, but patients in Group 2 also received a pharmacist counseling intervention in addition to the brochure. Outcomes were evaluated within intervention group and between intervention groups.

Results: The study included 299 (30.4%) and 100 patients (100.0%) in Groups 1 and 2 respectively who completed the baseline questionnaire, of whom 179 (59.8%) and 96 (96.0%) completed the follow-up questionnaire. At baseline, higher educational levels and possession of a drug allergy card were significantly associated with better knowledge about drug allergy. After intervention, Group 2 had significantly greater increases in mean overall knowledge scores than Group 1 (p<0.01) and also greater increases in the proportions self-reporting carrying and presenting drug allergy cards (p<0.05 and p<0.01).

Conclusions: Pharmacist counseling plus brochure may be more effective than brochure alone in promoting patients’ knowledge of drug allergy and drug allergy card importance.

Abstract 2193 | PDF Downloads 1537 Patient characteristics between different brochures in Phase 1 study Downloads 296


1. Joint Task Force on Practice Parameters; American Academy of Allergy, Asthma and Immunology; American College of Allergy, Asthma and Immunology; Joint Council of Allergy, Asthma and Immunology. Drug allergy: an updated practice parameter. Ann Allergy Asthma Immunol. 2010;105(4):259-273. doi: 10.1016/j.anai.2010.08.002

2. Executive summary of disease management of drug hypersensitivity: a practice parameter. Joint Task Force on Practice Parameters, the American Academy of Allergy, Asthma and Immunology, the American Academy of Allergy, Asthma and Immunology, and the Joint Council of Allergy, Asthma and Immunology. Ann Allergy Asthma Immunol. 1999;83(6 Pt 3):665-700.

3. Park CS, Kim TB, Kim SL, Kim JY, Yang KA, Bae YJ, Cho YS, Moon HB. use of an electronic medical record system for mandatory reporting of drug hypersensitivity reactions has been shown to improve the management of patients in the university hospital in Korea. Pharmacoepidemiol Drug Saf. 2008;17(9):919-925. doi: 10.1002/pds.1612.

4. Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: Results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol. 2003 Mar;90(3):342-347.

5. Jirapongsananuruk O, Bunsawansong W, Piyaphanee N, Visitsunthorn N, Thongngarm T, Vichyanond P. Features of patients with anaphylaxis admitted to a university hospital. Ann Allergy Asthma Immunol. 2007;98(2):157-162.

6. Sooksriwong C, Leelanitkul S. Perspectives on self-medication practices in Thailand. J Soc Adm Pharm. 2001;18(2):75- 80.

7. Sri-Ngernyuang L. Drug abundance: Situation of drugs and drug distribution in the villages of rural Thailand. Asia Pac J Public Health. 1996-1997;9:18-23.

8. Burapadaja S, Tantipathananandh P, Sirithunyalug B. Consumer’s opinions on reading a medicine Leaflet. Chiang Mai University Journal. 2004;3:155-167.

9. Radford A, Undre S, Alkhamesi NA, Darzi SA. Recording of drug allergies: are we doing enough? J Eval Clin Pract. 2007;13(1):130-137.

10. Gay KJ, Hill C, Bell T. Accuracy of drug-allergy recording in a District General Hospital. Int J Pharm Pract. 2009;17(4):253-235.

11. Khalil H, Leversha A, Khalil V. Drug allergy documentation--time for a change? Int J Clin Pharm. 2011;33(4):610-613. doi: 10.1007/s11096-011-9525-y

12. Johnson V, Croft C, Crane V. Counseling patients about drug allergies in the inpatient setting. Am J Health Syst Pharm. 2001;58(19):1855-1858.

13. Chaikoolvatana A, Chanakit T, Juengrakpong A. The evaluation of a recurrent Adverse Drug Reaction Prevention Program in the north-east region of Thailand. J Med Assoc Thai. 2006;89(5):699-705.

14. Demoly P, Kropf R, Pichler WJ, Bircher A. Drug hypersensitivity: questionnaire. Allergy. 1999;54(9):999-1003.

15. DeWitt JE, Sorofman BA. A Model for Understanding Patient Attribution of Adverse Drug Reaction Symptoms. Drug Inf J. 1999;33(3):907-920.

16. MacPherson RD, Willcox C, Chow C, Wang A. Anaesthetist's responses to patients' self-reported drug allergies. Br J Anaesth. 2006;97(5):634-639.

17. Valente S, Murray LP. Creative strategies to improve patient safety: allergies and adverse drug reactions. J Nurses Staff Dev. 2011;27(1):E1-5. doi: 10.1097/NND.0b013e31819b5f0b

18. Hannaford PC. Adverse drug reaction cards carried by patients. Br Med J (Clin Res Ed). 1986;292(6528):1109-1112.

19. Gomes E, Cardoso MF, Praça F, Gomes L, Mariño E, Demoly P. Self-reported drug allergy in a general adult Portuguese population. Clin Exp Allergy. 2004;34(10):1597-1601.

20. Jarernsiripornkul N, Chaisrisawadsuk S, Chaiyakum A, Krska J. Patient self-reporting of potential adverse drug reactions to non-steroidal anti-inflammatory drugs in Thailand. Pharm World Sci. 2009;31(5):559-564. doi: 10.1007/s11096-009-9310-3

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