MAXIMIZING OPPORTUNITIES FOR SKIN PRICK TESTING AT INITIAL ALLERGY CLINIC VISIT USING AN EDUCATIONAL BROCHURE

Abstract

Introduction Many atopic patients present to allergy clinic taking medications that interfere with allergy skin prick testing (SPT) due to lack of communication amongst providers, clinics and patients. We investigated the effect of a mailed brochure on rates of allergy SPT at an initial clinic visit. Methods A retrospective chart review was performed on new patients presenting to an Allergy/Immunology clinic from November 2016 to November 2017. An educational brochure describing the allergy SPT procedure and instructions for holding medications was mailed before the appointment. The effect of the intervention was analyzed via prospective chart review from November 2017 to May 2018. Research was exempt from IRB review. Results We reviewed 96 charts pre-intervention and 79 charts post-intervention that were appropriate for allergy SPT. The percentage of patients who were not taking interfering medications and successfully completed allergy SPT rose from 63% (n=60) prior to the intervention to 84% (66) after the intervention (p=0.002). Wait time for new patients decreased from three months to one week after the intervention. Of patients completing a post-intervention survey, 59% (47) reported they had received the brochure more than five days before the appointment. Steroid nasal sprays were held incorrectly by 12 patients, accounting for 86% of incorrectly held medications. Two (2%) adverse events occurred in association with the mailed brochure, namely an urticaria exacerbation and an episode of acute angioedema. Conclusions Our results suggest that communicating with patients via a mailed brochure is an effective intervention to increase the number of successful allergy SPT's during the initial visit.