title: The Effectiveness of Automatic Recommending System for Premedication in Reducing Recurrent Radiocontrast Media Hypersensitivity Reactions.
abstract: Non-ionic radiocontrast media (RCM) is rarely associated with hypersensitivity reactions. Premedication of patients who reacted previously to RCM with systemic corticosteroids and/or antihistamines can help reduce recurrent hypersensitivity reactions. However, premedication is still not prescribed in many cases for various reasons. This study aimed to determine the effectiveness of our novel RCM hypersensitivity surveillance and automatic recommending system for premedication.
  
  
  
  Hospitalized patients with a history of RCM hypersensitivity were identified in an electronic medical record system that included a mandatory reporting system for past adverse drug reactions. In 2009, a novel automatic prescription system was added that classified index RCM reactions by severity and dispensed appropriate corticosteroid and/or antihistamine pretreatment prior to new RCM exposures. The data from 12 months under the previous system and 12 months under the current system were compared. The two systems had similar overall premedication rates (91% and 95%) but the current system was associated with a significantly higher corticosteroid premedication rate (65% vs. 14%), which significantly reduced the breakthrough reaction rate (6.7% vs. 15.2%). The current system was also associated with increased corticosteroid and antihistamine premedication of patients with a mild index reaction (61% vs. 7%) and a reduction in their breakthrough reaction rate (6% vs. 15%).
  
  
  
  Premedication with corticosteroid and/or antihistamine, which was increased by our novel automatic prescription system, significantly reduced breakthrough reactions in patients with a history of RCM hypersensitivity.
authors.affiliation: Division of Allergy and Clinical Immunology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea ; Department of Health Medicine, Health Screening and Promotion Center, Asan Medical Center, Seoul, Korea.
authors.forename: Yun-Jeong
authors.initials: YJ
authors.lastname: Bae
authors.forename: Ye Won
authors.initials: YW
authors.lastname: Hwang
authors.forename: Sun-Young
authors.initials: SY
authors.lastname: Yoon
authors.forename: Sujeong
authors.initials: S
authors.lastname: Kim
authors.forename: Taehoon
authors.initials: T
authors.lastname: Lee
authors.forename: Yoon Su
authors.initials: YS
authors.lastname: Lee
authors.forename: Hyouk-Soo
authors.initials: HS
authors.lastname: Kwon
authors.forename: You Sook
authors.initials: YS
authors.lastname: Cho
authors.forename: Myung Jin
authors.initials: MJ
authors.lastname: Shin
authors.forename: Hee-Bom
authors.initials: HB
authors.lastname: Moon
authors.forename: Tae-Bum
authors.initials: TB
authors.lastname: Kim
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage* / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D003287:Contrast Media / Q000008:administration & dosage / Q000009:adverse effects*; D004342:Drug Hypersensitivity / Q000209:etiology / Q000517:prevention & control*; D057286:Electronic Health Records; D005260:Female; D006633:Histamine Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011292:Premedication / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D003287:Contrast Media; D006633:Histamine Antagonists