• Kitty De Clercq, Cals Jochen W L JWL Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, The Netherlands., and de Bont Eefje G P M EGPM Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, The Netherlands eefje.debo.
• Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University Medical Centre, The Netherlands.
• Ann Fam Med. 2020 Jul 1; 18 (4): 326-333.

PurposeIt is hypothesized that 90% of antibiotic allergies documented in patients' health records are not actual, potentially life threatening, type I allergies mediated by IgE. This distinction is important because such documentation increases antibiotic resistance, as more second-choice and broad-spectrum antibiotics are then used. Evidence is lacking regarding causes of this inappropriate documentation. To develop interventions aimed at improving documentation, we explored experiences of family physicians and pharmacists in this area.MethodsWe conducted a qualitative study among family physicians and pharmacists using focus group discussions, based on purposeful sampling and a naturalistic approach. Discussions were audio-recorded, transcribed verbatim, and analyzed in duplicate by means of constant comparative technique.ResultsWe conducted 4 focus group discussions among 34 family physicians and 10 pharmacists, from which 3 main themes emerged: (1) magnitude and awareness of the problem of inappropriate antibiotic allergy documentation, (2) origin of the problem, and (3) approaches for addressing the problem. Participants noted that the magnitude of contamination of medical files with inappropriate documentation leads to skepticism about current documentation. Major hindering factors are electronic health record systems and electronic communication. In addition, family physicians and pharmacists believed they had insufficient knowledge about antibiotic allergies and called for tools to rectify inappropriate allergy documentation and facilitate proper documentation going forward.ConclusionsFamily physicians and pharmacists perceive that few documented antibiotic allergies are in fact correct. Electronic health record barriers and communication barriers, as well as a lack of knowledge and facilitating tools, are main causes for numerous inappropriately documented antibiotic allergies and therefore targets for improving documentation in the future.© 2020 Annals of Family Medicine, Inc.

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