Attitude of practitioners towards drug allergies. Comparison between general practitioners' and allergists' attitudes. A qualitative study

Introduction. - Patients with an undocumented clinical history of drug allergy may be treated with alternate medication, to be prescribed by their general practitioner (GP). Guidelines on how this situation should be managed are missing. This study aims to study and compare the GPs', the allergists' and the medicine students' attitude towards drug allergy suspicions. Method. - This is a qualitative study in which private semi-directive interviews were conducted with each practitioner and a group interview with the medicine students. Results. - These practitioners' behaviors take into account the same facts but yet, are very different. They try to confirm the diagnosis by interviewing the patient. Then, they adjust their behavior according to the data collected, their doubts on the diagnosis, the assessment of the risk for the patient and the therapeutic indication. Some factors such as time constraints, unavailability of diagnostic tests in ambulatory care, lack of relevant hospital services, lack of communication between GPs and allergists may result in uncertainties in the provided diagnosis. The patient's choices must also be taken into account. The teaching process provided in relation to drug allergy is considered way too insufficient during medical studies. Conclusion. - Practitioners' behaviors for the management of drug allergy are influenced by their doubts on the diagnosis and the risks for the patient related to resuming the treatment. We provide a decision-tree based on a thorough medical interview during a specific consultation, taking into consideration the patient's ideas on hypersensitivity, and the collaboration with an allergist. (C) 2014 Elsevier Masson SAS. All rights reserved.