This post was mentioned on Twitter by jfahrni: Who should collect allergy information and how should it be done? http://ff.im/-b0tuo...

Great piece of writing. In the UK pharmacists have been out in the trenches for at least the last 25 years, performing just this sort of task.

However, with the advent of electronic systems there is a danger that it may be seen as an opportunity to do much more work remotely.

Some of our systems use Snomed CT as the underlying coding for allergy recording, and indeed I spent a substantial length of time producing a subset of terms suitable for allergy recording (think it was over 2000 causative agents). However, the user interface in some systems is not good enough and it will need skill and knowledge in order to correctly select and record the allergy. Many, possibly all, systems allow freetext entry either in addition or instead of coded entry if allergy entries.

A study carried out by a London hospital some years ago showed that nurses tended to record exactly what the patient said, and included terms such as phobias (spiders), preferences (Mondays), and humour (mother in laws) in recorded allergies. Whilst there is some merit in recording such things as they give a fuller picture if the patient they clearly have no use in computerised allergy checking. If nurses become accustomed to using the freetext entry for these things (or actual allergy causative agents) they will prevent the computer checking the agent against prescribed items.

I believe that pharmacists (of which I am one) have a huge role to play in the frontline, recording, checking, and amending allergy records and also educating others who have access to the electronic recording if allergies.

Pharmacists should be key people in the selection of prescribing systems. They have the knowledge to design and configure the allergy modules. They have the skills to teach the optimal use of such systems to the other clinical staff, in the same way that they currently teach safe prescribing, pain relief, inhaler technique and the rest either formally or informally.

I agree entirely with your article. Now, more than ever, pharmacists need to be out there alongside the patients. Technology can assist all of us to provide better care for our patients, but it needs careful monitoring, improvement and education of staff, all of which tasks are in the core skill set of the pharmacists. Hospital management needs to understand how important pharmacists are in the business of the incident (and litigation) prevention.

Best regards
Pauline

@psweetman