Allergies and adverse drug reactions: Clinical records versus patients' perceptions

Abstract

Introduction: Adverse drug reactions (ADRs) are a recognized cause of avoidable morbidity and mortality in healthcare systems throughout the world. Drug allergies are one type of ADR. The Clinical Negligence Scheme for Trusts standards require that information regarding drug allergies should be readily accessible in clinical records to prevent re-exposure to drugs that have previously caused harm.

Aims: To determine if patients' perceptions of ADRs in general, and drug allergies specifically, that they have experienced are documented in their clinical records.

Method: (i) Face-to-face interviews with 150 patients occupying beds on acute adult and elderly psychiatric wards in one National Health Service specialist mental health Trust; and (ii) examination of the clinical records belonging to these patients.

Results: Almost two thirds of patients had experienced an ADR. For 64 patients documentation of ADRs was either inaccurate or incomplete. Specifically, allergy documentation was either inaccurate or absent for 81 patients interviewed. The severity of the reaction did not seem to predict whether it would be documented or not.

Discussion: Documentation of ADRs is below acceptable standards in this psychiatric setting. This may be due to a number of factors, including the different perceptions of clinicians and patients with respect to the clinical significance of ADR experienced. Patients may be re-exposed to drugs that they perceive have previously caused them harm.

Declaration of interest: None.

Keywords:

• Adverse drug reactions
• drug allergies
• patients' perceptions
• documentation