Drug allergy is a common problem in Hong Kong, with up to 7% of the entire population’s medical records documented with a suspected drug allergy label. The most common labels are to penicillin or beta-lactam antibiotics, with 1 in every 50 people in Hong Kong are labelled with suspected “allergies” to these drugs. Unfortunately, the majority of these “allergy” labels are incorrect and more than 85% of patients found to be tolerant and able to take penicillins again after allergy workup.
The consequences of incorrect drug allergy labels are an overwhelming and a serious threat to patient safety. For example, incorrect penicillin labels are known to be associated with higher healthcare costs, as well as a myriad of negative clinical consequences – such as development of multi-drug resistant organisms and even increased patient mortality! More recently, there has also been massive public attention and fear to the potential of COVID19 vaccine associated allergies. Suspected cases of vaccine allergy have been detrimental to the vaccination campaign. The safe delabelling of such incorrect drug allergy labels are therefore of enormous public interest.
Drug allergy evaluation and delabelling of incorrect allergies are therefore crucial to patient safety. Despite this, expertise and specialist care for Immunology & Allergy remains extremely limited with only one Specialist in Immunology & Allergy working in the Hospital Authority. Given the lack of expertise but constantly-growing Immunology Clinic queues, strategic utilization of such precious resources are needed. Novel strategies have been designed and led by HKUMed to tackle this urgent health issue.
In this session, the feasibility, effectiveness and safety of a novel nurse-led, protocol-driven drug allergy delabelling strategy will be shared. The strategy has now been implemented as the Hong Kong Drug Allergy Delabelling Initiative (HK-DADI) across various Hospital Authority clusters as a “Hub and Spoke” model to more effectively tackle low-risk drug allergy delabelling. This “Hub and Spoke” model has been internationally recognized and now being implemented both across Hong Kong and other countries in the Asia Pacific region. The long term benefits of delabelling and effectiveness in other countries of HK-DADI await further prospective studies.
