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Patient characteristics and concerns about drug allergy: A report from the United States drug allergy registry

Blumenthal, K.G., Harkness, T., Phillips, E.J., Ramsey, A., Banerji, A., Samarakoon, U., Stone, C., Fu, X., Khan, D.A., Otani, I., Camargo, C.A., Zhang, Y. and Donelan, K. (2020) Patient characteristics and concerns about drug allergy: A report from the United States drug allergy registry. The Journal of Allergy and Clinical Immunology: In Practice, 8 (9). pp. 2958-2967.

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Drug allergy is frequently reported, but uncommonly confirmed with diagnostic testing. Although drug allergy assessments can improve clinical care, patient concerns may impact the optimal diagnostic approach and/or the clinical effectiveness of diagnostic testing.


To assess drug allergy patient concerns.


Using data from a multi-site, prospective longitudinal cohort study, the United States Drug Allergy Registry (01/16/2019-01/24/2020), we determined patient self-reported characteristics and qualitatively coded free-text patient concerns about their drug allergy/allergies. We assessed associations between patient characteristics and drug allergy concerns using multinomial logistic regression models.


Of 592 patients (age 49 [Standard Deviation 17] years, 74% Female, 88% white), the most commonly reported drug allergies were penicillins (78%), cephalosporins (12%) and sulfonamides (12%) with common reactions of rash (62%), hives (54%), itching (48%), flushing or facial redness (28%), and swelling or angioedema (24%). Patient concerns, coded from free-text, were optimal medication use (41%), no concern (17%), allergic reaction (14%), diagnosis (12%), and severe allergic reaction (12%). Using multinomial regression, the presence of drug allergy concerns increased with greater age, higher number of reported drug reactions, more antibiotic use, and certain reaction symptoms, most notably mouth or palate itching. Female sex was associated with increased severe allergic reaction concern. Poorer general and mental health was associated with increased allergic reaction concern.


Drug allergy patients were concerned about their options for medical treatment, having an allergic reaction, and receiving clarity about their diagnosis. Capturing and addressing patient concerns may improve the approach to drug allergy patients and/or the effectiveness of drug allergy testing.

Item Type: Journal Article
Murdoch Affiliation(s): Institute for Immunology and Infectious Diseases
Publisher: Elsevier
Copyright: © 2020 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology
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