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Adverse drug reactions

NICE calls on pharmacists to check patients’ drug allergy status

According to the National Institute for Health and Care Excellence, pharmacists should routinely check a patient’s drug allergy status before they dispense a prescription.

Elderly woman holding an NHS prescription

Source: Photofusion / Rex Features

Prescription forms should be redesigned to include information on an individual’s drug allergy status, says NICE

Pharmacists should routinely check a patient’s drug allergy status before they dispense a prescription, according to the first ever guideline on managing drug allergy from the National Institute for Health and Care Excellence (NICE), published on 3 September 2014.

Prescription forms should also be redesigned to include information on an individual’s drug allergy status and the drugs or drug classes to avoid, it recommends.

Whenever a person presents with a suspected drug allergy, a detailed record should be taken to include the generic and brand names of the drug, its strength and formulation and which drugs, or drug classes, should be avoided in future, according to the guideline.

NICE sets out the signs to look for when a drug allergy is suspected as well as the typical time it takes for symptoms to appear.

It details the steps to take when treating patients who are allergic to non-selective non-steroidal anti-inflammatory drugs and in what circumstances cyclooxygenase-2 inhibitors should be offered instead. NICE also makes recommendations about when patients with a suspected allergy should be referred to specialist services.

“The guideline stresses the care all healthcare professionals must take when documenting new drug allergies and the importance of sharing this information with patients and other healthcare professionals,” said Shuaib Nasser, a consultant in allergy at Addenbrooke’s Hospital, Cambridge.

“People should be provided with structured written information on drugs to avoid and be advised to check with their pharmacist before taking over-the-counter medicines,” added Nasser, the chairman of the guideline development group.

The guideline, which was out for public consultation earlier in 2014, comes as the number of recorded patient safety incidents involving a drug allergy continues to rise, and around 80% of cases occur in patients with a known drug allergy.

Data from 1996 to 2000 show that drug allergies and adverse drug reactions accounted for approximately 62,000 annual hospital admissions in England.

Between 1998 and 2005, serious adverse drug reactions rose 2.6-fold, according to NICE. Up to 15% of inpatients have their hospital stay prolonged as a result of an adverse drug reaction, it says. 

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20066334

Readers' comments (1)

  • If this triggers a redesign of the FP10 form then it's a good thing. With a move towards electronic transmission, there is no reason why the form shouldn't be A4 sized to allow more data to be transferred to the point of care (pharmacy). In my opinion, all dispensed FP10s should carry the identity and signature of both the pharmacist that carried out the clinical check on the prescribed items and the pharmacist or registered technician that carried out the accuracy check on the dispensed items. This provides a starting point for the issue of delegated dispensing and legal responsibility for accuracy to be properly resolved.

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