A digital app that helps clinicians diagnose drug allergies could reduce inpatient bed days and save the NHS thousands of pounds.
The Drug Allergy App has been in development since 2017 by Dr Shuayb Elkhalifa, consultant immunologist at Salford Care Organisation.
It has now been published in The Journal of Allergy and Clinical Immunology: In Practice, and Dr Elkhalifa is hoping it will now be rolled out more widely so he can continue capturing valuable data on the effectiveness of the app.
The aim of the app is to act as a clinical decision support tool for non-allergists to diagnose drug allergy correctly and support appropriate antibiotic prescribing as an attempt to address antimicrobial stewardship.
It uses a simple questionnaire-based algorithm built in a mobile application to support clinicians in collecting accurate history to diagnose drug allergy appropriately. It is designed to support the clinical practitioner to ask the appropriate questions during consultations to classify the previous drug allergies.
It can also be used as an educational tool for clinicians to learn about drug allergy classification and management.
Dr Elkhalifa said: “I am hoping the app will not only improve clinical outcomes and the wellbeing of our patients, but will empower our clinicians – who are non-allergists - to correctly identify allergies while also saving them time in the process.
“Perceived lack of time and preparedness to collect an accurate drug allergy history appear to be important barriers to appropriate antimicrobial prescribing. The Drug Allergy App may represent a useful clinical decision support tool as well as educational platform.”
Penicillin allergy overdiagnosis has been associated with inappropriate antibiotic prescribing, increased antimicrobial resistance, worse clinical outcomes, and increased healthcare costs.
A survey of prescribers revealed there was a tendency to adopt an over-cautious approach to prescribing alternative beta-lactams in patients with reported penicillin allergy.
The Drug Allergy App Clinical Algorithm was designed and based upon NICE - The National Institute for Health and Care Excellence. The algorithm and has the lowest risk for misclassification of outcomes compared to gold standard drug allergy investigations in the allergy and dermatology clinics.
Elizabeth Lamerton, associate director of pharmacy at the Northern Care Alliance, said: “The pharmacy team welcome the use of the allergy app as an important tool in providing medicines safety for our patients.”
One in three patients report at least one drug allergy, however, very few would truly have a drug allergy. There are more than 2,000 incidents involving drug allergies in the UK every year, which may cost the NHS £17million every year.
It is hoped that all doctors and prescribers who are not specialists in allergy, both in the community or hospital services, will use the Drug Allergy App.
The app has previously been used in a pilot with 1,438 patients admitted with Community Acquired Pneumonia (CAP). Overall, with this group of patients, the app would have saved 42.8 inpatient days and saved £8,283.