Table 1

Guiding principles for the AlABAMA intervention package

Intervention design objectivesKey features
To present the PAAP as a reliable and trusted approach to confirm allergy status
  • Present the PAAP as a trusted/scientific/official way to get a confirmed PAT result, for both clinicians and patients

To increase clinician’s confidence in referring patients, and patients’ motivation to attend, for PAT
  • Provide evidence on the potential harms of an incorrect penicillin allergy records and the process of testing in the information pack

  • Provide opportunity to address patients’ concerns about potential benefits and risks of testing by both clinicians and allergists during consultations before the allergy test and during the appointment at the immunology clinic

To motivate clinicians/patients to prescribe/take penicillin following a negative PAT test result
  • Provide information to clinicians about the clinical meaning of a test result and its implication as part of the information pack

  • Provide information to patients about the PAT (process) and the potential benefits of being able to take penicillin in the pretest intervention booklet

To increase clinicians’ ability to discuss PAT with patients
  • Provide training for general practice clinicians about penicillin allergy and PAT, including its accuracy, implications, benefits

To improve communication between primary and secondary care so that allergy status records are correct
  • Provide a clear and consistent approach to delabelling with support from colleagues in secondary care and preventing relabelling in the future

  • Provide information about who is responsible for ensuring patients understand the results and for updating the medical records during the site training and in the information pack

  • Provide clear and precise documentation of side effects during future courses of penicillin in the information pack

To provide easily accessible tools that are suitable for use by general practice clinicians
  • Make interventions materials for clinicians accessible, short, easy to follow, easy to implement and not increase workload

To provide easily accessible resources for patients
  • Make patients materials brief, easy to read, accessible

  • Make materials easy to carry with them at all time and that provide evidence of the results of their test

  • PAAP, penicillin allergy assessment pathway; PAT, penicillin allergy testing.