Impact of an electronic consultant system on hypersensitivity reactions to iodinated radiocontrast media: an observational study.
OBJECTIVE
To evaluate the impact of an electronic consultation support system on the incidence of hypersensitivity reactions to iodinated radiocontrast media (RCM).


METHODS
A retrospective observational study was conducted before and after the introduction of the consultation support system. The 1-year study period was divided into two 6-month periods: before and after 1 December 2012 (baseline and intervention periods, respectively), which was when our consultation support system was introduced. Data from examinations were collected retrospectively from the hospital information centre and problem reporting sheets in the radiology department. The primary outcome was the incidence of RCM reactions before and after the introduction of the consultation support system. Generalised estimating equations were used to account for the correlation between the same patients measured on multiple occasions.


RESULTS
There were 317/20,179 (1.6%) and 186/19,873 (0.9%) hypersensitivity reactions during the baseline and intervention periods, respectively. The consultation support system significantly decreased the odds of the occurrence of a RCM reaction (OR=0.59, 95% CI 0.49 to 0.71, p<0.001) compared with baseline. There was also a twofold increase in the premedication rate after initiation of the consultation support system (OR=2.05, 95% CI 1.16 to 3.65 p=0.01). However, there was no significant difference in the recurrence rate between the periods (OR=0.97, 95% CI 0.58 to 1.65, p<0.93).


CONCLUSIONS
The introduction of the consultation support system reduced the incidence of hypersensitivity reactions to RCM and increased the use of premedication in patients with known hypersensitivity to RCM.
Department of Internal Medicine, SMG-SNU Boramae Medical Center, Seoul, Korea Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Min-Suk
MS
Yang
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Sang-Il
SI
Choi
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Woo-Jung
WJ
Song
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Sae-Hoon
SH
Kim
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Hye-Ryun
HR
Kang
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Heung-Woo
HW
Park
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Sang-Heon
SH
Cho
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
Kyung-Up
KU
Min
Department of Radiology, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Jae-Hyoung
JH
Kim
Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam-si, Korea.
Yoon-Seok
YS
Chang
D003287:Contrast Media / Q000009:adverse effects*; D056911:Democratic People's Republic of Korea; D004342:Drug Hypersensitivity / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D007455:Iodine / Q000009:adverse effects*; D016347:Medical Records Systems, Computerized; D008875:Middle Aged; D011237:Predictive Value of Tests; D012008:Recurrence; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D012882:Skin Tests
D003287:Contrast Media; D007455:Iodine