The 3rd RAFT national collaborative project involving all networks was DALES, Drug Allergy Labels in the Elective Surgical population.
It was a three-day study commencing mid-2018 comprising Patient Questionnaire, Anaesthetist Survey and Patient Follow-Up on the day.
The Study
DALES was designed to evaluate the prevalence of patient-reported and documented allergy to drugs relevant to anaesthesia and to learn more about anaesthetists’ knowledge and attitudes to allergy.
The study took the form of questionnaires / interviews for quantitative analysis. This was a cross sectional, observational and descriptive study design:
Patient Questionnaire
This occurred across the country in multiple sites over 3 days within a 6-week study window. When patients attended hospital for planned surgery they were consented for a questionnaire about their allergies. Baseline data was collected from all patients attending for elective surgery, regardless of allergy status. Data was collected electronically at the bedside using the REDCap system and securely stored
Targeted Patient Follow-Up
Patients who reported allergy to B-lactams or opioids were followed up post-op if they were due to receive these drugs. An investigator reviewed the anaesthetic and drug charts and note how the drug allergy was documented and what was given. Any changes to the documentation of allergy were recordedAny episode of unexpected patient instability that took place in the peri-operative period was recorded
Anaesthetist Survey
All anaesthetists and prescribing anaesthetic practitioners working during the study period were invited to take part in a survey about attitudes to drug allergy labels in the elective perioperative setting
Which hospitals in Wales took part?
Cardiff and Vale UHB: University Hospital of Wales
Collaborators: Anna Williams, Jessica Phillips, Emily Murphy, Matthew Soanes, Laura Allen
PI: Danielle Huckle
Abertawe Bro Morgannwg UHB:
Morriston, Singleton
Collaborators: Nadine Jones, Benjamin O’Donovan, Harriet Pudge, Alexandra Cormack, Catherine Chapman, Sean O’Beirn
PI: Nathan Tweed
Princess of Wales
Collaborators: Tanya Smith, Mike Cooper
PI: Rhidian Jones
Betsi Cadwaldr UHB: Wrexham Maelor
Collaborators: Amanda Skingle, Jana Anandarajah, Nowfal Rahman
PI: Andy Campbell
Hywel Dda UHB: Prince Philip, West Wales General
Collaborators: Brigitte Baxter, Gareth James
PI: Alun Thomas
Cwm Taf UHB: Royal Glamorgan, Prince Charles
Collaborators:
PI: Aneurin Bevan UHB:
Royal Gwent
Collaborators: Alexander Photiou, Anthony Rimmer, Nicholas Gibson, Roisin Flanaghan, Nitin Bhalla
PI: Tamas Szakamy
Neville Hall
Collaborators: Pete Collett, Jake Moss, Helen Ross
PI: Vincent Hamlyn
Publications
Published in December 2020:
https://www.sciencedirect.com/science/article/abs/pii/S0007091220306413
Published in July 2021:
https://bjanaesthesia.org/article/S0007-0912(21)00345-7/fulltext