Intérêt et confiance des médecins généralistes dans les tests d’allergies médicamenteuses

Abstract

ObjectiveEvaluation of the interest and confidence of general practitioners in allergy testing for drug hypersensitivity, their intentions regarding the reintroduction of a drug testing negatively, and their practice in the event of suspected drug allergy. MethodsA descriptive and observational study conducted among 342 GPs in the Sarthe region of France based on responses to a questionnaire posted out in April 2019. ResultsOne hundred and seventy-three practitioners (50.6%) completed the questionnaire, 83% of whom indicated that they referred fewer than half of their patients with suspected drug hypersensitivity to an allergist. The main reasons for referral were the extent and frequency of drug use and the seriousness of the reaction. Fourteen percent of respondents did not refer their patients systematically to an allergist due to the existence of alternate drugs and to the long waiting times for an appointment. Sixty to 70% of GPs considered themselves relatively poorly informed about drug allergy testing (skin testing and challenge tests). However, 81% declared that they trust drug allergy testing, with 60 to 70% indicating their intention of reintroducing a treatment where tests have ruled out any associated drug hypersensitivity, regardless of the types of tests performed. The reasons given for prescribing a treatment once more were patient's wishes (37%), availability of alternate treatments (36%), and fear of relapse (12%). Access to an allergist and training were considered unsatisfactory. Most experienced practitioners (in term of number of years of practice) refer fewer patients to allergists. ConclusionDespite a lack of knowledge, GPs trust drug allergy testing. The number of patients referred to allergists is low, especially among more experienced GPs, with the shortage of drug-specialized allergists and their uneven geographical distribution perhaps being the two main contributing factors. Training could be improved through the use of new media sources.