{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T01:48:27Z","timestamp":1775612907361,"version":"3.50.1"},"reference-count":27,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["accpjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Am Coll Clin Pharm"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There is a lack of data on the impact of implementing an interprofessional approach in ambulatory clinics to de\u2010label penicillin\u2010allergic patients (PA) in diverse and lower\u2010income populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A quality improvement (QI) interprofessional adult PA assessment\/intervention protocol was implemented at two resource\u2010limited ambulatory sites over 4\u2009months, utilizing a post\u2010group\u2010only quasi\u2010experimental study design. Pharmacists performed allergy assessments\/Pen\u2010FAST scores with nonallergic histories directly de\u2010labeled. Nonpregnant patients with Pen\u2010FAST scores less than 3 were offered amoxicillin direct oral challenges (DOC), and scores of 3 or greater were offered allergist referrals. Data collection included demographics, allergy information, Pen\u2010FAST score, and outcomes. The primary outcome was the percentage of interviewed patients de\u2010labeled. Secondary outcomes included the percentage de\u2010labeled through different modalities, allergist referrals, and 3\u2010 and 6\u2010month antibiotic use and relabeling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 717 and 388 PA patients were identified at Sites 1 and 2, respectively. Interviews occurred in 228 patients, with 151 (66.2%) and 77 (33.8%) from Sites 1 and 2. The median age (interquartile range [IQR]) was 56\u2009years (41\u201364), with 168 (73.7%) identified as female. A total of 130 (57%) patients had a Pen\u2010FAST score less than 3. Successful allergy de\u2010labeling was achieved in 74 of 228 (32.5%) patients. De\u2010labeling occurred in 60 patients by allergy assessment and 14 patients through DOC. Allergist referrals occurred in 93 patients. Of de\u2010labeled patients, 8 (10.8%) and 11 (14.9%) received penicillin within 3 and 6\u2009months. Relabeling occurred in one patient within 6\u2009months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This QI initiative was effective in de\u2010labeling 33% of inaccurate PAs across two ambulatory care clinics with diverse populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jac5.70205","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T04:41:19Z","timestamp":1775018479000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Quality Improvement Project to Decrease Inaccurate Penicillin Allergies in Resource\u2010Limited Ambulatory Care Clinics"],"prefix":"10.1002","volume":"9","author":[{"given":"Cadhan","family":"McFadden","sequence":"first","affiliation":[{"name":"Wegmans School of Pharmacy St. John Fisher University  Rochester New York 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USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6304-0593","authenticated-orcid":false,"given":"Lisa","family":"Avery","sequence":"additional","affiliation":[{"name":"Wegmans School of Pharmacy St. John Fisher University  Rochester New York USA"},{"name":"St. Joseph's Health  Syracuse New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Centers for Disease Control and Prevention \u201cClinical Features of Penicillin Allergy \u201d2025 https:\/\/www.cdc.gov\/antibiotic\u2010use\/hcp\/clinicalsigns\/index.html#:~:text=10%25%20of%20U.S. 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