Factors Affecting Patients’ Notification of Drug Allergy History

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ชุติมา ระฆังทอง
สงวน ลือเกียรติบัณฑิต

Abstract

Objective: To determine the factors affecting patients’ notification of drug allergy history. Methods: The subjects were 250 patients with drug allergy history seeking care from a general hospital during the study period. The researcher interviewed the patients on their notification of drug allergy history to health professionals on the present visit either by verbal or by showing allergy card, the frequency of notification in the past and the carrying of drug allergy card. Then, the subjects completed the questionnaires measuring independent variables including advantages and disadvantages of the notification of allergy history, perceived sensitivity of allergy, trust on preventive system for drug allergy of the hospital, expectation of health professionals, knowledge on drug allergy, barrier of notification on drug allergy history, perceived self responsibility, attitudes toward communication of sensitivity history. The patients were then again interviewed on their knowledge on drug sensitivity. Results: 72.4% of subjects informed health professionals on their drug allergy history by verbal (39.60%), by showing allergy card (29.20%) and by both methods (3.60%).  About 49% of patients reported they would inform the health professionals even they were not asked.  Fifty two percent of the subjects brought with them the allergy card on this visit to hospital, while 68.40% always or nearly always carried the card with them. The majority of subjects knew the name of allergic drugs (70.40 %), management of drug allergy (40.00%) and preventive measures for repeated allergy (16.40%). Logistic regression analysis revealed that the significant predictors of the reporting of drug allergy history either by verbal or by using cards were perceived sensitivity, attitudes toward reporting, knowledge on allergic drug name and perceived barrier on the reporting. The significant predictor of reporting the history by showing the cards was expectation of health professionals on notification. The significant predictors of active reporting of the history were attitudes toward reporting and knowledge on allergic drug name. Multiple regression analysis showed that the significant predictors for frequency of showing allergy cards were severity of allergy and perceived sensitivity. The significant predictors for frequency of verbal communication of allergy history were perceived benefit of informing the history, knowledge on drug name and perceived barrier in reporting the history. The significant predictors of always carrying allergy card were severity of drug allergy, perceived sensitivity of allergy, expectation of health providers on reporting the history, attitudes toward the reporting and confidence in the preventive systems of the hospital. Conclusion: A large number of patients did not notify their drug allergy history to health professionals. The findings on factors affecting patients’ notification of drug allergy history could be used to design an intervention for improving the drug allergy notification by patients.

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Research Articles

References

1. ภูมิใจ อ่างแก้ว, กฤติยา สธนเสาวภาคย์. นโยบายด้านความปลอดภัยของผู้ป่วย. จดหมายข่าวเภสัชกรรมโรงพยาบาล, 2551; 1:5-6.

2. Thong BY, Leong KP, Tang CY, Chng HH. Drug allergy in a general hospital: results of a novel prospective inpatient reporting system. Ann Allergy Asthma Immunol. 2003;90:342–7.

3. Gruchalla RS. Drug allergy. J Allergy Clin Immunol 2003;111(2 suppl):s548-9

4. Bates DW, Cullen DJ, Laird N, Petersen LA, Small SD, Servi D, et al. Incidence of adverse drug events and potential adverse drug events: implication for prevention. JAMA.1995;274:29–34.

5. Lesar TS, Briceland L, Stein D. Factors related to errors in medication prescribing. JAMA. 1997;277 :312–7.

6. Jones TA, Como JA. Assessment of medication errors that involved drug allergies at a university hospital. Pharmacotherapy 2003;23:855-860

7. Leape LL, Bates DW, Cullen DJ, Cooper J, Demonaco HJ, Gallivan T, et al. Systems analysis of adverse drug events.JAMA. 1995;274:35–43.

8. Bates DW, Teich JM, Lee J, Seger D, Kuperman GJ, Ma’Luf N, et al. The impact of computerised physician order entry on medication error prevention. J Am Med Inform Assoc. 1999; 6:313–21.

9. นิสา เลาหพจนารถ, ปิยเมธ โตสุขุมวงศ์, พวงเพ็ญ ฤทธีวีรกุล. การประเมินผลงานส่งมอบบัตรแพ้ยาแก่ผู้ป่วยในที่มีประวัติแพ้ยาโดยเภสัชกร. วารสารเภสัชกรรมโรงพยาบาล 2550; 17 :40-8.

10. วลัยรัตน์ วงศ์เพ็ญทักษ์. การประเมินผลงานส่งมอบบัตรแพ้ยาแก่ผู้ป่วยโรงพยาบาลพระพุทธชินราช. รายงานการประชุมวิชาการงานเฝ้าระวังความปลอดภัยจากการใช้ยา : ศูนย์ติดตามอาการอันไม่พึงประสงค์จากการใช้ผลิตภัณฑ์สุขภาพ สำนักคณะกรรมการอาหารและยา กระทรวงสาธารณสุข; 2550.

11. Green SB. How many subjects dose it take to do a regression analysis?. Multivariate Behavioral Research 1991;26:499-510.

12. Glanz K, Lewis FM, Rimer BK. Health behavior and health education: theory, research and practice. San Franciso: Jossey-Bass Publishers; 1990.

13. ฐิตินันท์ สมุทรไชยกิจ. ความเข้าใจเกี่ยวกับการแพ้ยาของผู้ป่วยนอกโรงพยาบาลศรีนครินทร์.รายงานการประชุมวิชาการงานเฝ้าระวังความปลอดภัยจากการใช้ยา : ศูนย์ติดตามอาการอันไม่พึงประสงค์จากการใช้ผลิตภัณฑ์สุขภาพ สำนักคณะกรรมการอาหารและยา กระทรวงสาธารณสุข; 2550.