Design:  The majority of patient-reported NSAID adverse reactions are not consistent with hypersensitivity. We developed an evidence-based clinical pathway to help non-Allergy providers safely prescribe NSAIDs to appropriate patients with reported NSAID allergies. The algorithm will help identify patients who may receive NSAIDs without further evaluation, as well as those who would benefit from formal Allergy assessment.

Main Findings:  We developed an NSAID hypersensitivity clinical pathway and a dedicated NSAID Allergy Referral orderset through the EHR at our institution. We hope to increase the number of referrals for reported NSAID allergy (non-AERD) evaluation in our outpatient Allergy practice from <1 to 3 referrals per month, with the goal of providing these patients with additional anti-inflammatory and analgesic options.

Impact on Practice:  We hope to both provide education to non-Allergy providers through use of this algorithm and help guide NSAID prescription patterns and appropriate Allergy referrals. This algorithm will be particularly useful for patients with chronic pain, or those with rheumatologic, cardiovascular, or pregnancy-related indications for aspirin/NSAID use.

Submitted by Lily Li from Brigham and Women's Hospital