Skip to main content

Table 1 Health professional assessment of clinical scenarios for type and severity of reaction and level contraindication

From: Adverse drug reaction classification by health professionals: appropriate discrimination between allergy and intolerance?

Health profession Type of reaction
N (%)
Severity of reaction
N (%)
Level of contraindication
N (%)
Allergy Intolerance Mild Moderate Severe Absolutely Relatively Use with caution
Allergy
 Control—Augmentin, anaphylaxis (severe, absolutely contraindicated)
  Medical (n = 160) 159 (99.4) 0 1 (0.6) 2 (1.3) 156 (97.5) 158 (98.8) 0 1 (0.6)
  Nurse (n = 50) 49 (98.0) 0 1 (2.0) 2 (4.0) 46 (92.0) 46 (92.0) 3 (6.0) 0
  Pharmacist (n = 96) 94 (97.9) 2 (2.1) 0 3 (3.1) 93 (96.9) 94 (97.9) 1 (1.0) 1 (1.0)
  Medical student (n = 88) 86 (97.7) 1 (1.1) 0 1 (1.1) 86 (97.7) 87 (98.9) 0 0
  Overall (n = 394) 388 (98.5) 3 (0.76) 2 (0.51) 8 (2.0) 381 (96.7) 385 (97.7) 4 (1.0) 2 (0.51)
 Carbamazepine, Stevens–Johnson syndrome (severe, absolutely contraindicated)
  Medical (n = 160) 128 (80.0) 31 (19.4) 0 17 (10.6) 142 (88.8) 148 (92.5) 12 (7.5) 0
  Nurse (n = 50) 26 (52.0) 24 (48.0) 0 12 (24.0) 26 (52.0) 26 (52.0) 20 (40.0) 4 (8.0)
  Pharmacist (n = 96) 80 (83.3) 16 (16.7) 0 3 (3.1) 93 (96.9) 93 (96.9) 3 (3.1) 0
  Medical student (n = 88) 67 (76.1) 20 (22.7) 0 5 (5.6) 83 (89.8) 79 (89.8) 9 (10.2) 0
  Overall (n = 394) 301 (76.4) 91 (23.1) 0 37 (9.4) 344 (87.3) 346 (87.8) 44 (11.2) 4 (1.0)
Intolerance
 Control—PPI, headache (mild, use with caution)
  Medical (n = 160) 1 (0.6) 157 (98.1) 157 (98.1) 3 (1.9) 0 0 47 (29.4) 113 (70.6)
  Nurse (n = 50) 6 (12.0) 43 (86.0) 45 (90.0) 4 (8.0) 0 1 (2.0) 17 (34.0) 30 (60.0)
  Pharmacist (n = 96) 1 (1.0) 94 (98.0) 91 (94.8) 5 (5.2) 0 0 33 (34.4) 62 (65.6)
  Medical student (n = 88) 0 88 (100) 83 (94.3) 5 (5.7) 0 0 26 (11.4) 62 (70.5)
  Overall (n = 394) 8 (2.0) 382 (96.9) 376 (95.4) (4.8) 0 1 (0.25) 123 (31.2) 267 (67.8)
 Statin, rhabdomyolysis (severe, use with caution)
  Medical (n = 160) 32 (20.0) 124 (77.5) 0 45 (28.1) 115 (71.9) 92 (57.5) 59 (36.9) 9 (5.6)
  Nurse (n = 50) 10 (20.0) 38 (76.0) 5 (10.0) 18 (36.0) 25 (50.0) 21 (42.0) 18 (36.0) 10 (20.0)
  Pharmacist (n = 96) 15 (15.6) 80 (83.3) 0 19 (19.8) 77 (80.2) 49 (51.0) 41 (42.7) 6 (6.3)
  Medical student (n = 88) 13 (14.8) 73 (82.9) 0 11 (12.5) 76 (86.4) 53 (60.2) 32 (36.4) 2 (2.3)
  Overall (n = 394) 70 (17.8) 315 (79.9) 5 (1.3) 93 (23.6) 293 (74.4) 215 (54.6) 150 (38.1) 27 (6.9)
 Azathioprine, myelosuppression, hepatitis (moderate, absolutely contraindicated)
  Medical (n = 160) 24 (15.0) 130 (81.3) 0 65 (40.6) 76 (47.5) 49 (30.6) 77 (48.1) 33 (20.6)
  Nurse (n = 50) 15 (30.0) 34 (68.0) 0 31 (62.0) 19 (38.0) 17 (34.0) 22 (44.0) 11 (22.0)
  Pharmacist (n = 96) 17 (17.7) 79 (82.3) 1 (1.0) 54 (56.3) 40 (41.7) 20 (20.8) 54 (56.3) 22 (22.9)
  Medical student (n = 88) 13 (14.8) 74 (84.1) 1 (1.1) 50 (56.8) 36 (40.9) 27 (30.7) 54 (61.4) 6 (6.8)
  Overall (n = 394) 69 (17.5) 317 (80.4) 2 (0.5) 200 (50.7) 171 (43.4) 113 (28.7) 207 (52.5) 72 (18.3)
 ACE, angioedema (moderate, absolutely contraindicated)
  Medical (n = 160) 109 (68.1) 48 (30.0) 14 (8.8) 82 (51.3) 63 (39.4) 110 (68.8) 45 (28.1) 4 (2.5)
  Nurse (n = 50) 38 (76.0) 11 (22.0) 4 (8.0) 30 (60.0) 16 (32.0) 29 (58.0) 18 (36.0) 3 (6.0)
  Pharmacist (n = 96) 73 (76.0) 23 (23.9) 1 (1.0) 30 (31.3) 65 (67.7) 87 (90.6) 9 (9.4) 0
  Medical student (n = 88) 74 (84.1) 14 (15.9) 9 (10.2) 51 (58.0) 28 (31.8) 36 (40.9) 46 (52.3) 6 (6.8)
  Overall (n = 394) 294 (74.6) 96 (24.4) 28 (7.1) 193 (49.0) 172 (43.7) 262 (66.5) 118 (29.9) 13 (3.3)
 NSAIDs, hives (moderate, relatively contraindicated)
  Medical (n = 160) 144 (90.0) 14 (8.8) 23 (14.4) 121 (75.6) 14 (8.8) 67 (41.9) 76 (47.5) 15 (9.4)
  Nurse (n = 50) 39 (78.0) 9 (18.0) 17 (34.0) 31 (62.0) 2 (4.0) 14 (28.0) 6 (12.0) 30 (60.0)
  Pharmacist (n = 96) 91 (94.8) 5 (5.2) 19 (19.8) 64 (66.7) 13 (13.5) 42 (43.8) 37 (38.5) 16 (16.7)
  Medical student (n = 88) 85 (96.6) 3 (3.4) 10 (11.4) 67 (76.1) 10 (11.4) 31 (35.2) 49 (55.7) 8 (9.1)
  Overall (n = 394) 359 (91.1) 31 (7.9) 69 (17.5) 283 (71.8) 39 (9.9) 154 (39.1) 168 (42.6) 69 (17.5)
 Beta-blocker, shortness of breath (moderate, relatively contraindicated)
  Medical (n = 160) 18 (11.2) 139 (86.9) 37 (23.1) 112 (70.0) 8 (5.0) 28 (17.5) 109 (68.1) 19 (11.9)
  Nurse (n = 50) 22 (44.0) 26 (52.0) 15 (30.0) 28 (56.0) 5 (10.0) 14 (28.0) 20 (40.0) 14 (28.0)
  Pharmacist (n = 96) 4 (4.2) 91 (94.8) 28 (29.2) 61 (63.5) 7 (7.3) 13 (13.5) 57 (59.4) 25 (26.0)
  Medical student (n = 88) 12 (13.6) 76 (86.4) 31 (35.2) 53 (60.2) 4 (4.5) 11 (12.5) 61 (69.3) 16 (18.2)
  Overall (n = 394) 56 (14.2) 332 (84.3) 111 (28.2) 254 (64.5) 24 (6.1) 66 (16.8) 247 (62.7) 74 (18.8)
 Morphine, hives (mild, use with caution)
  Medical (n = 160) 114 (71.3) 44 (27.5) 93 (58.1) 64 (40.0) 2 (1.25) 22 (13.8) 104 (65.0) 33 (20.6)
  Nurse (n = 50) 28 (56.0) 20 (40.0) 21 (42.0) 28 (56.0) 0 7 (14.0) 26 (52.0) 16 (32.0)
  Pharmacist (n = 96) 66 (68.8) 30 (31.3) 35 (36.5) 58 (60.4) 3 (3.1) 11 (11.5) 63 (65.6) 22 (22.9)
  Medical student (n = 88) 82 (93.2) 5 (5.7) 38 (43.2) 48 (54.5) 1 (1.1) 10 (11.4) 63 (71.6) 14 (15.9)
  Overall (n = 394) 290 (73.6) 99 (25.1) 187 (47.5) 198 (50.3) 6 (1.5) 50 (12.7) 256 (65.0) 85 (21.6)
 Erythromycin, GI complaint (moderate, relatively contraindicated)
  Medical (n = 160) 5 (3.1) 151 (94.4) 101 (63.1) 58 (36.3) 0 2 (1.3) 61 (38.1) 95 (59.4)
  Nurse (n = 50) 5 (10.0) 43 (86.0) 17 (34.0) 31 (62.0) 1 (2.0) 4 (8.0) 24 (48.0) 21 (42.0)
  Pharmacist (n = 96) 3 (3.1) 93 (96.9) 69 (71.9) 23 (24.0) 1 (1.0) 1 (1.0) 26 (27.1) 66 (68.8)
  Medical student (n = 88) 4 (4.5) 83 (94.3) 38 (43.2) 49 (55.7) 0 0 49 (55.7) 38 (43.2)
  Overall (n = 394) 17 (4.3) 370 (93.9) 225 (57.1) 161 (40.9) 2 (0.5) 7 (1.8) 160 (40.6) 220 (55.8)
  1. Cells may not add up to 100% due to missing data
  2. Those columns highlighted in italics are the correct answers