PREVENTING EXPOSURE TO ALLERGENS

To advocate for pharmacy workforce participation in the collection, assessment, documentation, and reconciliation of a complete list of allergens and intolerances pertinent to medication therapy, including food, excipients, medications, devices, and supplies; further, 

To promote the education of the healthcare team and patients on the differences between medication-related allergic reactions and medication intolerances; further,

To encourage vendors of electronic health records to create readily available and distinct data fields with consistent designations for medication allergies and intolerances; further,

To advocate that vendors of medication-related databases incorporate and maintain information about medication-related allergens and cross-reactivity; further, 

To encourage the accurate and complete documentation of allergens and intolerances within the electronic medical record, including detailed descriptions of the reactions occurring upon exposure, for the purpose of clinical decision-making; further,

To advocate that pharmacists actively review allergens and intolerances pertinent to medication therapy and minimize patient and healthcare worker exposure to known allergens, as feasible.

Rationale

The common theme of several ASHP policies is that patients may be exposed to potentially life-threatening allergens in items encountered in the medication-use process (e.g., natural rubber latex, drugs, drug product excipients, devices, and supplies). Pharmacy workforce involvement in collection, assessment, and documentation of a complete list of allergens pertinent to the medication-use process, including food, excipients, medications, devices, and supplies, would assist in clinical decision-making. Members of the pharmacy workforce should also minimize patient and healthcare worker exposure to known allergens, for example by limiting or banning the use of latex gloves in pharmacies and striving for latex-safe medication formularies. Although allergy information is becoming more readily accessible though the electronic health record (EHR) and clinical decision support systems, some well-known cross-sensitivities are good candidates to be included in medication-related databases.

Only about 5-10% of all medication-related adverse events are allergic in nature. Patients are often labeled with an allergy to many drugs on the basis of a side effect or intolerances such as headache or GI disturbance. Allergen misidentification and documentation can be detrimental to patient care by preventing the use of optimal drug agents or by causing re-exposure to a true allergen. Pharmacists and pharmacy technicians can help clarify and provide detailed documentation in the EHR regarding patient allergens. Furthermore, there is inconsistent standards on how and where allergies are located in the EHR and as such, there should be a consistent and standardized approach to documentation.