{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T12:26:36Z","timestamp":1769775996583,"version":"3.49.0"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":22,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100008333","name":"University of Alabama at Birmingham","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008333","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1TR004771"],"award-info":[{"award-number":["UM1TR004771"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to evaluate the characteristics of drug allergy alerts (DAAs) and identify false-positive alerts by analyzing prior drug administration records.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed DAAs fired to providers with prescribing authority in 2023 at a large academic medical center in the Southeast to identify data elements that could help reduce clinically irrelevant alerts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 101\u2009492 DAAs were triggered in 2023, with a 98.9% override rate. Alerts were fired for 9111 unique patients (an average of 11.1 alerts per patient). Only 9.7% DAAs had a definite match between the prescribed drug and documented allergen, with the remaining 90.3% fired for different drugs under the same class or allergen group. Overall, 70% DAAs were triggered for patients with prior administration of the drug triggering the alert, of these, 74% (52% of all DDAs) occurred in patients who had received the prescribed drug after initial allergy documentation, and 79% (56% of all DAAs) received the same drug again after 2023. Patients who had received prescribed drug previously, definite match were more likely to be overridden than no match (OR\u2009=\u20091.18, 95% CI: 1.03-1.33, P\u2009=\u2009.013) with a slightly higher override rate (98.9%% [n\u2009=\u200971\u2009357] vs 98.8% [n\u2009=\u200930\u2009135]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Most DAAs occurred in patients previously exposed to the alerting medication, often after allergy documentation, and over half of the patients continued to receive the same drug after 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Future research should focus on examining strategies to incorporate tolerance assertions into DAA logic to reduce false-positives without compromising safety.<\/jats:p>\n                  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