CD11 Cutaneous allergy documentation in primary care

Abstract Communication of patients’ positive patch test results to primary care is vital. This is why all of our cutaneous allergy clinic letters have a standard sentence asking general practitioners to update allergy information in the patients’ primary care records. However, it is unclear whether this instruction is followed. Therefore, the aim of our project was to assess the completeness of cutaneous allergy documentation in primary care. All patients with positive patch test reactions in 2019 were identified and their allergy records were reviewed from (i) the Emergency Care Summary (ECS); (ii) Clinical Portal (CP), a patient information system; and (iii) TrakCare (TC), a patient management system. Data were marked as complete record, partial record, no record or wrong record. In total, 305 patients were identified, with 195 (63.9%) having more than one contact allergy. Complete records were found for 23.3% (71 of 305) on ECS, 0.3% (1 of 305) on CP and 0.3% (1 of 305) on TC. Partial records were found for 7.2% (22 of 305) on ECS, 19.3% (59 of 305) on CP and 1% (3 of 305) on TC. Partial records included incomplete recording, allergens recorded under nonspecific terms, for example ‘allergy unspecified’, and allergens recorded under umbrella terms such as ‘plant allergy’. No records were found for 69.5% (212 of 305) on ECS, 80.0% (244 of 305) on CP, and 98.7% (301 of 305) on TC. An incorrect record was found for 0.3% (1 of 305) on CP and inaccuracies were noted under the umbrella terms. We have found that cutaneous allergy is poorly recorded in primary care and that the three systems do not appear to be linked. There was no specific pattern to the allergens excluded. Documentation of correct allergy is important as medicament and excipient allergy information will influence the choice of topical agent prescribed and avoid patient harm. To our knowledge a review of primary care cutaneous allergy documentation has not been published previously. We wish to highlight the potential information gap that might exist, the challenge in recording these data and the consequences on patient care. It would also be useful if primary care cutaneous allergy information could link with the general practitioner electronic prescribing system in the future so that prescribers get an alert if a topical agent containing an excipient the patient is allergic to is being prescribed.