How accurate is the label “allergic to iodinated contrast agents”?

Abstract

The majority of patients carrying the label "allergic to ICAs" had no record of a prior hypersensitivity reaction to ICAs.

Cephalexin, Cefaclor, and Ampicillin: Points in the Picture of β-Lactam Cross-Reactivity

“…Macy et al1 work did not delineate historical reaction information (eg, intolerance was not separated from hypersensitivity), they rightfully point out that antibiotic prescribing is dictated by the information contained in the EHR. The suboptimal state of the EHR has been well-documented,[8][9][10][11][12] including inaccurate and incomplete data, entered by members of the medical team with widely varying levels of training, but usually lacking drug allergy expertise 11. Macy et al fill a void in b-lactam cross-reactivity population data, but improvement in EHR documentation would be hugely beneficial for completing the picture.…”

Acute adverse drug reactions following cardiac catheterization: evidence-based guidance for providers and systems

“…The rate of ADR was 27.7% for those given the same contrast without premedication, 17.3% for those given the same contrast with premedication, 5.2% for those given a different contrast without premedication, and 2.7% for those given a different contrast with premedication. Of course, the quality of documentation regarding prior contrast exposure and reactions is a significant barrier to this strategyat one hospital system, only 16.6% of patients marked as "allergic to iodinated contrast agents" had a documented hypersensitivity reaction (23). In the era of electronic medical records, providers and care systems looking to avoid ADRs must work to improve documentation quality.…”

Allergy entry and deletion in the electronic health record

“…1,2 However, prescribers override over 90% of allergy alerts intended to protect patients from adverse drug events, 3 recognizing that many EHR drug allergies are incorrect and/or inconsequential to patient care. The EHR allergy section contains missing reaction details, 4 discrepancies with patient interview, 5,6 and data entered by providers with limited drug allergy training and knowledge. 7,8 Given that incomplete and inaccurate EHR allergy entries affect future prescribing, 9 we aimed to assess drug allergy entry, deletion, and accumulation; to identify provider types recording allergy data; and to assess the reaction types that lead to allergy entry and deletion.…”