AsianScientist (Feb. o6, 2025) – Allergy labels help healthcare professionals ensure that patients aren’t treated with medication that harms them. Recent research shows that these labels are often wrongly applied, limiting patients’ treatment options instead of helping them.
A previous study showed that of the 6-7% of Hong Kong population with suspected drug allergies, 20% of these were linked to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Aspirin, a NSAID with anti-platelet effects, is a first-line treatment for cardiovascular diseases like stroke, the second-leading cause of death globally. Early treatment with aspirin can reduce the risk of a recurring stroke by up to 60%, but those with NSAID allergies cannot be given aspirin, potentially leading to poorer treatment outcomes.
An interdisciplinary study from the LKS Faculty of Medicine of the University of Hong Kong (HKUMed) led by undergraduate medical student Cheryl Tsui Cheuk-wun and supervised by Philip Li Hei, clinical assistant professor from the Department of Medicine, aimed to determine the impact and rate of inaccurate NSAID allergy labels on stroke outcomes.
The study analysed data from electronic healthcare records between 2008 to 2014, finding that stroke patients were more likely to have NSAID allergy labels compared to the general population.
Those with NSAID allergy labels were often prescribed an alternative medication instead of aspirin, and faced significantly higher rates of mortality, peripheral vascular disease, and major adverse cardiovascular events.
Upon testing, the researchers found that four of the five stroke survivors they were able to contact were not allergic to NSAIDs, despite medical records labelling them as such.
“Patients were often astonished to learn that the allergy labels they had for years were incorrect, and that they could have safely used aspirin all along,” said Tsui. ‘As an undergraduate medical student, it is incredibly rewarding to realise that my research during my Enrichment Year can significantly influence clinical practice and patient outcomes,’ she added.
“It is important for patients with unverified drug allergies to undergo evaluation to see if they can safely use NSAIDs again,” said Gary Lau Kui-kai, director of HKU Stroke, and Clinical associate professor in neurology in the Department of Medicine at HKUMed. The researchers advocated for measures to mitigate the issue of inaccurate allergy labelling, particularly for patients who are both at risk for cardiovascular disease and have NSAID allergies in their records. They suggest that lower risk individuals could undergo nurse-led triage systems that have proven effective in other drug allergy initiatives.
This study emphasised the need for expanded drug allergy testing in Hong Kong. “The research revealed that the majority of drug allergy labels in Hong Kong may be inaccurate, yet most patients have never gone through a proper drug allergy evaluation,” said Li. “These mislabelled allergies compel patients to use less-effective medications, which can pose significant health risks, including potentially dangerous or even fatal consequences.”
He encouraged the implementation of innovative strategies to increase the availability of drug allergy testing, such as empowering community pharmacists to evaluate drug allergies in collaboration with HKUMed.
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Source: Medicine of the University of Hong Kong ; Image: Shelly Liew/ Asian Scientist Magazine
The article can be found at: NSAID Allergy Labels Associated With Mortality and Cardiovascular Outcomes in Stroke
Disclaimer: This article does not necessarily reflect the views of AsianScientist or its staff.
