Assessment of knowledge and practices of non-steroidal anti-inflammatory drug hypersensitivity among healthcare workers: a cross-sectional case-based survey.

Background: Non-steroidal anti-inflammatory drugs hypersensitivity reactions (NHRs) are one of the most common drug hypersensitivity reactions encountered in clinical practice. The ability of healthcare workers (HCWs) to recognise, classify and manage NHRs is important for patients' safety.

Aims: The study aimed to assess HCWs' knowledge and practices (KPs) on NHRs.

Methods: This was a cross-sectional online questionnaire case-based study on NHRs, involving clinical HCWs at two tertiary hospitals in Malaysia.

Results: A total of 247 respondents comprising 217 doctors and 30 clinical pharmacists, aged between 24 and 49 years, were recruited. Overall, only 15.8% of the HCWs had adequate KPs on NHRs. Years of clinical experience (≤10 vs >10 years) were significantly associated with adequacy of NHR knowledge (odds ratio: 0.17 (confidence interval: 0.08-0.35), P < 0.05). On average, the dermatology-specialised doctors scored better than other groups, with 58.7% (n = 25) answering correctly. Comparatively, this group also performed better in diagnosing and categorising NHRs, at 81.9%. When compared to the dermatology-specialised group, clinical pharmacists, non-dermatology specialised doctors and non-specialised doctors were six, 16 and 41 times more likely to have inadequate knowledge on NHRs respectively. The overall knowledge on the management of NHRs was poor across the groups (31%, n = 77). Interestingly, 57.1% (n = 141) of overall respondents thought that prescribing adrenaline autoinjectors was needed for anaphylaxis secondary to drugs, and 29.6% were still unaware of the utilisation of serum tryptase in confirming anaphylaxis.

Conclusions: The overall KPs of HCWs' on NHRs were found to be inadequate, specifically in their management. Increased efforts on periodic educational programmes for HCWs on NHRs are urgently needed.