The British Society for Allergy and Clinical Immunology (BSACI) has recently raised concerns about allergy testing in pharmacies.
They site a major problem being that pharmacy training involves education about medicines, not about clinical disease, patient history taking, psychology etc. This means that pharmacists do not know what the possibilities for diagnosis are in patients who present with, say, a blocked nose.
The BSACI committee concludes that the new pharmacist training scheme for allergy testing and diagnosis has not provided useful algorithms with danger signs suggesting referral. Also pharmacists cannot examine patients and unlike nurses do not have ready access to a doctor for advice. Thus some patients with serious disease may be misdiagnosed to their detriment.
They go on to highlight a major problem with allergy testing is the very high false-positive rate (around 50% for IgE tests to inhalants and even higher (40-80%) for peanut extract). The concept of any investigations into the minefield of food allergy and intolerance by pharmacists is not sensible, especially considering the rate of both false negative as well as false positive responses on IgE testing, which could prove dangerous if relied upon. For example an individual can be anaphylactic to Brazil nut yet have a negative specific IgE test. Other patients may be advised to take expensive allergen avoidance measures unnecessarily.
They remain fundamentally opposed to the concept of allergy diagnosis by pharmacists for the reasons expressed and because the initiative looks like a “quick fix “ which will allow the Department of Health off the hook rather than forcing them to genuinely improve allergy provision.
