{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,2]],"date-time":"2026-03-02T11:49:21Z","timestamp":1772452161222,"version":"3.50.1"},"reference-count":17,"publisher":"Oceanside Publications Inc.","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["allergy asthma proc"],"published-print":{"date-parts":[[2025,1,1]]},"abstract":"<jats:p><jats:bold>Background:<\/jats:bold> Unconfirmed penicillin allergies over time lead to poor health outcomes and increased health-care cost. Health disparities (HD) can create barriers in optimizing penicillin allergy care.  <jats:bold>Objective:<\/jats:bold> The objective was to characterize HDs in our\n primary care-led amoxicillin challenge (PLAC) delabeling pathway within a universal coverage health care system.  <jats:bold>Methods:<\/jats:bold> In three outpatient clinic sites, 41,104 patients were screened, and 1,749 patients were discovered to have penicillin allergies. Of the 1,749 patients\n with penicillin allergy, 336 (ages 4 months to 76 years) were determined to be candidates for PLAC. A retrospective chart review was completed after 1 year of PLAC implementation to compare demographic characteristics and HD core categories (neighborhood living type, economic stability, background\n education status, and access to care) between those who completed and those who did not complete their PLAC appointment. All candidates underwent the same PLAC protocol and had universal health coverage that reduced health cost.  <jats:bold>Results:<\/jats:bold> Of 336 PLAC candidates (45.8%),\n 154 presented for their PLAC appointment and had their penicillin allergy removed without adverse outcomes. One hundred and eighty-two candidates (54.2%) did not complete a PLAC appointment and retained their penicillin allergy label. Candidates who did not complete their PLAC appointment\n were older (p = 0.001) and white (p = 0.006), and did not identify as officers (p = 0.04). There was no significant difference in neighborhood type or gender between the groups. In candidates ages \u2265 19 years, those without proactively scheduled appointments more commonly (p &lt; 0.001)\n did not complete their PLAC appointment; whereas proactive scheduling increased delabeling from 5.8% to 91.3% in candidates ages \u2265 19 years. Of the 199 candidates with proactively scheduled PLAC appointments, those with less perceived economic stability and background education status (enlisted\n members) were more likely not to attend their PLAC appointment (p &lt; 0.001).  <jats:bold>Conclusion:<\/jats:bold> Results of our study suggest that our PLAC protocol provides a foundation of decreased HDs to successfully delabel patients at low risk of penicillin allergy when scheduling appointments\n for all and controlling for health-care cost.<\/jats:p>","DOI":"10.2500\/aap.2025.46.240079","type":"journal-article","created":{"date-parts":[[2024,12,31]],"date-time":"2024-12-31T04:30:58Z","timestamp":1735619458000},"page":"52-58","source":"Crossref","is-referenced-by-count":2,"title":["Health disparities investigated in a primary care penicillin allergy removal pathway"],"prefix":"10.2500","volume":"46","author":[{"given":"David","family":"Mari","sequence":"first","affiliation":[{"name":"From the Allergy and Immunology Department, Lackland Air Force Base, San Antonio, Texas;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kelley","family":"Henson","sequence":"additional","affiliation":[{"name":"Division of Pediatric Medicine, Joint Base Langley-Eustis, Hampton, Virginia;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"Day","sequence":"additional","affiliation":[{"name":"Allergy and Immunology Department, Walter Reed National Military Medical Center, Bethesda, Maryland; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Mcglynn","sequence":"additional","affiliation":[{"name":"Division of Pediatric Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Taylor","family":"Banks","sequence":"additional","affiliation":[{"name":"Division of Pediatric Medicine, Naval Medical Center Portsmouth, Portsmouth, Virginia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1355","reference":[{"key":"B1","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/j.anai.2010.08.002","article-title":"Drug allergy: an updated practice parameter","volume":"105","year":"2010","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B2","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.anai.2023.02.024","article-title":"Penicillin delabeling: ready for pediatric primary care","volume":"130","author":"White","year":"2023","journal-title":"Ann Allergy Asthma Immunol"},{"key":"B3","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.anai.2022.12.023","article-title":"Penicillin allergy delabeling: opportunities for implementation and dissemination","volume":"130","author":"Samarakoon","year":"2023","journal-title":"Ann Allergy Asthma 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validation of a penicillin allergy clinical decision rule","volume":"180","author":"Trubiano","year":"2020","journal-title":"JAMA Intern Med"},{"key":"B8","doi-asserted-by":"crossref","first-page":"1579","DOI":"10.1016\/j.jaci.2021.02.034","article-title":"Health disparities in allergic and immunologic conditions in racial and ethnic underserved populations: a Work Group Report of the AAAAI Committee on the Underserved","volume":"147","author":"Davis","year":"2021","journal-title":"J Allergy Clin Immunol"},{"key":"B9","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jaip.2022.12.001","article-title":"Penicillin allergy evaluation and health equity: a call to action","volume":"11","author":"Arasaratnam","year":"2023","journal-title":"J Allergy Clin Immunol Pract"},{"key":"B10","article-title":"Social determinants of health"},{"key":"B11","doi-asserted-by":"crossref","first-page":"625","DOI":"10.1542\/hpeds.2021-006462","article-title":"Association of sociodemographic factors with reported penicillin allergy in pediatric inpatients","volume":"12","author":"Hampton","year":"2022","journal-title":"Hosp Pediatr"},{"key":"B12","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1016\/0021-9681(87)90171-8","article-title":"A new method of classifying prognostic comorbidity in longitudinal studies: development and validation","volume":"40","author":"Charlson","year":"1987","journal-title":"J Chronic Dis"},{"key":"B13","first-page":"460","article-title":"Penicillin allergy delabeling can decrease antibiotic resistance, reduce costs, and optimize patient outcomes","volume":"37","author":"Lee","year":"2020","journal-title":"Fed Pract"},{"key":"B14","article-title":"Health insurance coverage: Early release of estimates from the National Health Interview Survey","author":"Cohen","year":"2022","journal-title":"National Center for Health Statistics"},{"key":"B15","article-title":"2022 demographics profile 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