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Patients can have allergic reactions to molecules of varying degrees of severity, ranging from a rash to anaphylactic shock. This important Clinical Decision Support tool enables a practitioner to be automatically alerted when a prescribed medication contains active ingredients that are known to cause an allergy in their patient.

 

Overview

In the MIMS data, products are broken down into molecules and the molecules are assigned to substance classes according to their chemical constituents, based on the assumption that molecules of similar chemicals cause a similar reaction in the patient.

For example, for the Drug and Allergy decision support module, the molecule Amoxycillin Trihydrate is assigned to the Penicillins class. If a patient record indicates an allergy to Amoxycillin Trihydrate either directly or indirectly (via a cross-sensitive substance class), prescribing Augmentin Duo Forte Tablets will trigger an alert as it also belongs to the Penicillins class.

When a clinician prescribes a medication, the application considers what other medications are being prescribed. Each medication is broken down into its individual molecules that are checked to see if they are in the substance class to which the patient is allergic.

This module is available in our MIMS Integrated product.

Types of Alerts

There are three types of alerts that can be triggered. The alerts are based on the three levels of checks performed.

The first is the molecule self-check, which is based on checking if the patient has an allergy to the molecule being prescribed. For instance, if the doctor prescribes lamotrigine for a patient, the software application conducts a search to determine if the patient has recorded an allergy to lamotrigine, and issues an alert if a match is found.

The second type of alert is triggered by an allergy to a substance class, which is based on checking if the drug being prescribed belongs to a class of drugs to which the patient is allergic. In clinical practice, it is assumed that if a patient is allergic to a drug in a particular substance class, they are allergic to other drugs in the same class. MIMS editors assign molecules to allergy substance classes to facilitate this kind of allergy alert. Each substance class has one or more molecules assigned to it, and molecules may be assigned to multiple substance classes.

The third type of alert is triggered by cross-referencing substance classes. Sometimes if a patient is allergic to a certain class of products, they are also allergic to products in another class. This relationship is represented by cross-sensitivity tables that contain associations between classes of products that are also likely to cause an allergic reaction. The tables are based on studies that show that patients allergic to one class of products are also allergic to the other. Penicillins and cephalosporins are two classes of products known to have such cross sensitivity. There are over 200 cross sensitive allergy substance class pairs.

Example

Below is an example of the type of information supplied when an allergy alert is triggered.

Example
A patient has exhibited an allergic reaction to penicillin and she is prescribed Cephalexin Oral Capsule.

Patient Allergy Penicillins (substance class)
Prescribed Cephalexin Oral Capsul

Output:
Alert: Patient may be allergic to the prescribing item, Cephalexin Oral Capsule.

Availability

This highly valued decision support tool is available for integration into clinical software applications via the MIMS Integrated product.