Inappropriate Antibiotic Allergy Documentation in Medical Files: A Qualitative Study on Family Physicians’ and Pharmacists’ Experiences
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* Ada Yu
* Michael E. Johansen

The *Annals of Family Medicine* encourages readers to develop a learning community to improve health care and health through enhanced primary care. Participate by conducting a journal club. We encourage diverse participants to think critically about important issues affecting primary care and act on those discussions.1

## HOW IT WORKS

In each issue, the *Annals* selects an article and provides discussion tips and questions. Post a summary of your conversation in our online discussion. (Open the article and click on the eLetters tab, and submit a comment.) Discussion questions and information are online at: [https://www.AnnFamMed.org/content/AJC](https://www.AnnFamMed.org/content/AJC).

## CURRENT SELECTION

### Article for Discussion

 De Clercq K, Cals JWL, de Bont EGPM. Inappropriate antibiotic allergy documentation in health records: a qualitative study on family physicians’ and pharmacists’ experiences. Ann Fam Med. 2020; 18( 4): 326– 333.[Abstract/FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6ODoiMTgvNC8zMjYiO3M6NDoiYXRvbSI7czoyMzoiL2FubmFsc2ZtLzE4LzQvaWlpLmF0b20iO31zOjg6ImZyYWdtZW50IjtzOjA6IiI7fQ==)

### Discussion Tips

Qualitative research offers an opportunity to gain a richer understanding of why things are happening.

As clinicians, we have pondered similar questions the researchers asked family physicians and pharmacists about antibiotic allergies. Consider how you deal with patient-reported allergies as a physician. How granular are your system’s reporting mechanisms? Is your electronic medical record connected to the pharmacist’s medical record?

### Discussion Questions

*   What question is asked by this study and why does it matter?

*   How does this study advance beyond previous research and clinical practice on this topic?

*   What is a focus group? How strong is this study design for answering the question? What are weaknesses of this type of study? 
    
    *   ○ What is saturation?

*   What methods did the authors use to minimize bias in the conduct and analysis of the study?

*   To what degree can the findings be accounted for by: 
    
    1.  How participants were selected or excluded?
    
    2.  How the findings were interpreted?

*   What are the main study findings? 
    
    *   ○ How did you feel about the grouping of quotes into 3 main categories?
    
    *   ○ Did the highlighted quotes support the analysis? Did you identify with any of the quotes?
    
    *   ○ What is a fish-bone diagram? Does it help you understand what is going on here?

*   How comparable is the study sample to your location? What is your judgment about the transportability of the findings? 
    
    *   ○ Do you relate to the focus group participants?

*   What contextual factors are important for interpreting the findings? 
    
    *   ○ What is an allergy registration?

*   How might this study change your practice? Policy? Education? Research?

*   What challenges do you see with trying to improve the reporting of antibiotic allergies?

*   What are the next steps in interpreting or applying the findings?

*   What researchable questions remain?

*   © 2020 Annals of Family Medicine, Inc.

## References

1.  Stange KC, Miller WL, McLellan LA, et al. *Annals* Journal Club: It’s time to get RADICAL. Ann Fam Med. 2006; 4(3): 196–197. [https://AnnFamMed.org/cgi/content/full/4/3/196](https://AnnFamMed.org/cgi/content/full/4/3/196).
    
    [FREE Full Text](http://www.annfammed.org/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiRlVMTCI7czoxMToiam91cm5hbENvZGUiO3M6ODoiYW5uYWxzZm0iO3M6NToicmVzaWQiO3M6NzoiNC8zLzE5NiI7czo0OiJhdG9tIjtzOjIzOiIvYW5uYWxzZm0vMTgvNC9paWkuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9)