Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice
Objectives About 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these are likely to be truly allergic. In the ALABAMA (Allergy Antibiotics and Microbial resistance) feasibility trial, primary care patients with penicillin allergy were randomised t...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e057471.full |
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| author | Sarah Tonkin-Crine Robert West Sinisa Savic Jonathan Sandoe Ly-Mee Yu Sue Pavitt Ushma Galal Christopher C Butler Marta Wanat Bethany Shinkins Mina Davoudianfar Emily Bongard Sue H Pavitt Philip Howard Catherine Porter Mandy East Marta Santillo Louise Savic Joanne Fielding Jenny Boards Catherine E Porter Jonathan AT Sandoe |
| author_facet | Sarah Tonkin-Crine Robert West Sinisa Savic Jonathan Sandoe Ly-Mee Yu Sue Pavitt Ushma Galal Christopher C Butler Marta Wanat Bethany Shinkins Mina Davoudianfar Emily Bongard Sue H Pavitt Philip Howard Catherine Porter Mandy East Marta Santillo Louise Savic Joanne Fielding Jenny Boards Catherine E Porter Jonathan AT Sandoe |
| collection | DOAJ |
| description | Objectives About 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these are likely to be truly allergic. In the ALABAMA (Allergy Antibiotics and Microbial resistance) feasibility trial, primary care patients with penicillin allergy were randomised to penicillin allergy assessment pathway or usual care to assess the effect on health outcomes. A behavioural intervention package was developed to aid delabelling. This study aimed to investigate patients’ and clinicians’ views of penicillin allergy testing (PAT).Design We conducted a mixed-methods process evaluation embedded within the ALABAMA trial, which included a clinician survey, a patient survey (at baseline and follow-up) and semistructured interviews with patients and clinicians.Settings The study was conducted in primary care, as part of the feasibility stage of the ALABAMA trial.Participants Patients and primary care clinicians.Results Clinicians (N=53; 52.2%) were positive about PAT and its potential value but did not have previous experience of referring patients for a PAT and were unsure whether patients would take penicillin after a negative allergy test. Patients (N=36; 46%) were unsure whether they were severely allergic to penicillin and did not fear a severe allergic reaction to penicillin. Clinician interviews showed that they were already aware of the benefit of PAT. Interviews with patients suggested the importance of safety as patients valued having numerous opportunities to address their concerns about safety of the test.Conclusions This study highlights the positive effects of the ALABAMA behavioural intervention for both patients and clinicians.Trial registration number NCT04108637; ISRCTN20579216; Pre-results. |
| format | Article |
| id | doaj-art-dd0f586d663047669ded9fbcc6f73a73 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-dd0f586d663047669ded9fbcc6f73a732025-01-24T02:15:15ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-057471Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice Sarah Tonkin-Crine0Robert West1Sinisa Savic2Jonathan Sandoe3Ly-Mee Yu4Sue Pavitt5Ushma Galal6Christopher C Butler7Marta Wanat8Bethany Shinkins9Mina Davoudianfar10Emily Bongard11Sue H PavittPhilip Howard12Catherine Porter13Mandy EastMarta Santillo14Louise Savic15Joanne Fielding16Jenny Boards17Catherine E Porter18Jonathan AT SandoeNuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKDepartment of Behavioural Science and Health, University College London, London, UKUniversity of Leeds and Leeds Teaching Hospitals NHS Trust, Faculty of Medicine and Health, Leeds, UK2 Leeds Teaching Hospitals NHS Trust, Leeds, UKsenior medical statisticianDental Translational and Clinical Research Unit, Faculty of Medicine and Health, University of Leeds, Leeds, UKNuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UK7 Nuffield Department of Primary Health Care Sciences, University of Oxford, Oxford, UK3 Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UKWarwick Screening & Warwick Evidence, Warwick Medical School, University of Warwick, Coventry, UKNuffield Department of Primary Care Health Sciences, Clinical Trials Unit, University of Oxford, Oxford, UKNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UKSchool of Healthcare, University of Leeds, Leeds, UKCentre for Trials Research, Cardiff University College of Biomedical and Life Sciences, Cardiff, UKNuffield Department of Primary Care Health Sciences, Oxford University, Oxford, UKDepartment of Anaesthesia, Leeds Teaching Hospitals NHS Trust, Leeds, UK2Department of Neuroscience, Central Clinical School, Faculty of Medicine, Nursing and Health Science, Monash University, Melbourne, VIC, AustraliaLeeds Teaching Hospitals NHS Trust, Leeds, Leeds, UKDental Translational and Clinical Research Unit, School of Dentistry, University of Leeds, Leeds, West Yorkshire, UKObjectives About 6% of the UK general practice population has a record of a penicillin allergy but fewer than 10% of these are likely to be truly allergic. In the ALABAMA (Allergy Antibiotics and Microbial resistance) feasibility trial, primary care patients with penicillin allergy were randomised to penicillin allergy assessment pathway or usual care to assess the effect on health outcomes. A behavioural intervention package was developed to aid delabelling. This study aimed to investigate patients’ and clinicians’ views of penicillin allergy testing (PAT).Design We conducted a mixed-methods process evaluation embedded within the ALABAMA trial, which included a clinician survey, a patient survey (at baseline and follow-up) and semistructured interviews with patients and clinicians.Settings The study was conducted in primary care, as part of the feasibility stage of the ALABAMA trial.Participants Patients and primary care clinicians.Results Clinicians (N=53; 52.2%) were positive about PAT and its potential value but did not have previous experience of referring patients for a PAT and were unsure whether patients would take penicillin after a negative allergy test. Patients (N=36; 46%) were unsure whether they were severely allergic to penicillin and did not fear a severe allergic reaction to penicillin. Clinician interviews showed that they were already aware of the benefit of PAT. Interviews with patients suggested the importance of safety as patients valued having numerous opportunities to address their concerns about safety of the test.Conclusions This study highlights the positive effects of the ALABAMA behavioural intervention for both patients and clinicians.Trial registration number NCT04108637; ISRCTN20579216; Pre-results.https://bmjopen.bmj.com/content/12/6/e057471.full |
| spellingShingle | Sarah Tonkin-Crine Robert West Sinisa Savic Jonathan Sandoe Ly-Mee Yu Sue Pavitt Ushma Galal Christopher C Butler Marta Wanat Bethany Shinkins Mina Davoudianfar Emily Bongard Sue H Pavitt Philip Howard Catherine Porter Mandy East Marta Santillo Louise Savic Joanne Fielding Jenny Boards Catherine E Porter Jonathan AT Sandoe Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice BMJ Open |
| title | Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice |
| title_full | Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice |
| title_fullStr | Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice |
| title_full_unstemmed | Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice |
| title_short | Mixed-methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in UK general practice |
| title_sort | mixed methods evaluation of a behavioural intervention package to identify and amend incorrect penicillin allergy records in uk general practice |
| url | https://bmjopen.bmj.com/content/12/6/e057471.full |
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