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Penicillin Delabeling
A video-based survey "nudging" penicillin allergy reassessment.
PARTNER
Dr T. Wang
BC Children's Hospital
The Digital Lab
Type of work
Research Study
technology
Overview
Rethinking Penicillin Allergy
Penicillin allergy is commonly reported in pediatric patients, with 5-8% claiming to have an allergy, though true penicillin allergies are much lower, as studies show a significant overestimation of drug allergies. In one study, only 1% of children had a clinically suggested allergy, and just 0.1% had a true allergy, with over 90% of those reporting penicillin allergies found to tolerate it. Misclassification or outgrowing the allergy may explain the discrepancy, yet patients with reported allergies are often prescribed less effective, more toxic, or more expensive antibiotics, leading to negative clinical outcomes like increased hospitalizations, antibiotic resistance, and higher costs. Medical centers have established procedures for reassessing penicillin allergies, but motivating individuals to seek reassessment is challenging. The Theory of Planned Behavior (TPB), which focuses on attitudes, subjective norms, and perceived control, can help guide behavior change by using social pressures to influence decisions. In this project, we explored how media forms, particularly video featuring a healthcare professional, can act as a "social nudge" to encourage penicillin allergy reassessment, grounded in TPB principles.
Research & Design
Promoting Re-Evaluation through Engaging Video Content
The role of different forms of media may influence the effectiveness of a message and its impact on behaviour. Video media has demonstrated greater efficacy in behavior influence compared to text alone; examples include an obesity prevention intervention where video viewers exhibited reduced body mass index and lower daily energy intake compared to those who received their information through text.
With that in mind, we developed custom surveys that can help educate patients and caregivers on penicillin allergy through remote education, leveraging engaging text and video content. By emphasizing the common misconceptions surrounding penicillin allergies as told by a physician, particularly through video-based education, we explored participants' willingness to seek re-evaluation.
Impact/Potential Impact
We All Play a Role in Antibiotic Stewardship
Findings of this research study will inform whether or not text or video-based symptom assessments are more impactful and could drive the development of new tools, and the redevelopment of existing symptom assessment tools. Further, this study may greatly impact patients and our healthcare system. If patients suspected of not having an allergy based on the survey were reassessed and found not to be allergic they would be able to confidently use penicillin rather than less effective alternative antibiotics, while simultaneously reducing the burden of antibiotic resistance and excessive hospital visits on our healthcare system. Reassessment would also help to identify true penicillin allergies, and ensure those patients continue to get adequate treatment.