An instruction sheet for Skin Prick test (SPT) was formulated by Multi-Disciplinary Team

Abstract Description

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Authors (including presenting author) :

Lit PKM(1), Chan LFI (2), Yau YS (2), Ng TM (3), Ho CH (5), Lo PY (4), Sum CYK (1), Chan WMJ (1)

Affiliation :

(1) Respiratory Division, Department of Medicine, Queen Elizabeth Hospital (2) Department of Paediatric, Queen Elizabeth Hospital (3) Department of Pharmacy, Queen Elizabeth Hospital (4) Department of ENT, Queen Elizabeth Hospital (5) Rheumatology Division, Department of Medicine, Queen Elizabeth Hospital

Introduction :

Skin prick testing (SPT) is an essential test procedure to confirm sensitization in IgE-mediated allergic disease in patients with, asthma, rhinoconjunctivitis, urticaria, atopic eczema and food or drug allergy. Some medications may interfere with the test results and provide incorrect interpretation if patients taking antihistamines or other medications prior to the test. Varied standard about information list of medication to be withheld occurred in different department.

Objectives :

To formulate an instruction sheet (IS) with a list of medication to be withheld according to international standard and guidelines in a multi-disciplinary collaboration.

Methodology :

An IS “Important notes for SPT” was formulated with multi-disciplinary and cross departmental collaboration including Respiratory, Paediatric, ENT, Rheumatology and Pharmacy. Medication list that may interfere the result and the abstinence period was included and it will be given and explained to patient before the test. Oral antihistamines, mast cell stabilizer, antidepressants, humanized monoclonal anti-IgE antibody and topical calcineurin inhibitors over test areas was included in the list. HAHO Information Technology Department was contacted to incorporate the IS into the SPT investigation request of CMS system. The IS will be automatically print out after SPT request was made through CMS system. The IS can serve three purposes: 1) A checklist reminder for doctors and nurses 2) Education pamphlet to patients 3) Improve the test accuracy and prevent unnecessary adjournment of the scheduled appointment.

Result & Outcome :

The “Important notes for Skin Prick Test” was formulated and has been launched in April 2014. 542 patients was monitored and educated with the IS by the doctors and nurses. All patients , nurses and doctors appreciated it as a safety reminder for them. The unnecessary appointment adjournment has been significantly decreased in department of Medicine from thirty-six episodes to 2 episodes in 2013 & 2017 respectively The formulation of the IS instruction sheet with multi-disciplinary and cross departmental collaboration facilitates international standardization, enhances accuracy of SPT procedures and demonstrates the treatment effectiveness and efficiency.