Implementation of a Pharmacist-Led Penicillin Allergy Interview at a Veterans Care Facility.

BACKGROUND: Evaluating a patient's β-lactam allergy involves a thorough review of electronic health records (EHRs), penicillin skin test, and observed oral challenge. The purpose of this study was to evaluate the impact of pharmacist-led penicillin allergy delabeling solely through an interview using the Allergy to β-Lactam Evaluation (ABLE) process. METHODS: This single-facility, retrospective cohort study reviewed EHR notes. Patient eligibility for allergy profile modifications was determined using guidance from the ABLE process. Interviews were conducted with patients meeting inclusion criteria. A progress note was entered into the EHR following completion of the interview. Patients were compared to a historical control group and matched for allergy severity (immunoglobulin E [IgE]-mediated allergy, unknown, adverse drug reaction [ADR], and severe cutaneous or other non-IgE-mediated reaction). The primary outcome was the number of patient allergy ADRs that were removed or changed on their profile. RESULTS: Six of 35 patients in the interviewed group had allergy profile modifications. The number of patients with a penicillin allergy/ADR modified regardless of change in their antibiotic regimen was statistically higher in the interviewed group compared with the control group: 6 (17.1%) vs 0 (0%) (P < .03). CONCLUSIONS: The study findings support the use of the ABLE process for penicillin allergy/ADR modification or clarification. Although the sample size was small, the ABLE process has the ability to positively impact individuals with inappropriate penicillin allergy documentation in the EHR.