Allergy Delabeling in Antibiotic Stewardship - Evaluations

The RENEW clinical intervention is designed to evaluate the impact of a comprehensive beta lactam (BL) allergy delabeling intervention on clinical outcomes among patients hospitalized with a hematologic malignancy (HM). HM patients are at a high risk of infection-related complications but are limited to antibiotic therapy based on self-reported allergies. The RENEW intervention will test the impact of a pharmacist-led BL allergy delabeling intervention on clinical outcomes and antibiotic use in hospitalized patients with HM.

The implementation of clinical interventions are often affected by non-clinical factors including workflow challenges and the beliefs of patients, their families, and clinical staff.

The RENEW-EVAL study is a concurrent mixed methods process evaluation of the RENEW intervention that aims to identify the social and behavioral factors that shape implementation of the intervention and to measure implementation outcomes including feasibility, acceptability, and fidelity.

Three types of data will be gathered by the research team as part of the RENEW-EVAL project: 1) semistructured interviews with patients and clinicians, (2) ethnographic observations of the delivery of the RENEW intervention, and 3) surveys assessing patient and clinician attitudes towards BL allergy delabeling, and implementation outcomes.

Inclusion criteria

Patient participants:

• a diagnosis of a hematologic malignancy (lymphoma, leukemia, myeloma)
• a prior label applied to their medical record to indicate a beta lactam allergy
• hospitalized as an inpatient to an oncology service at the time the study is conducted

Clinician participants:

• member of the primary inpatient care team

Exclusion criteria

Patient participants:

• meet one of the exclusionary criteria for the RENEW clinical intervention

Clinician participants:

• no exclusions