(as of February 2025)
Hub-and-Spoke Framework
New centres will be initially designated as “Spokes” and affiliated with “Hubs” centres for support
Experienced centres with evidence of commitment towards the support and education with other drug allergy centres of excellence in education and research will be designated as “Hubs”.
All drug allergy centres of excellence should demonstrate competencies in all the following :
Diagnostics
- Able to take a detailed and relevant drug allergy history, with focus on risk stratification
- Ascertain between drug allergy and different types of adverse drug reactions
- Differentiate clinically between the various forms of hypersensitivity reactions
- Select appropriate in vivo and in vitro tests based on individual patient presentations
Investigations
- Conduct pre-evaluation counselling and take informed consent for allergy testing
- Knowledgeable and able to interpret the results of various types of in-vivo tests, such as skin prick, intradermal and patch tests
- Recognize the in vitro options for drug allergy testing
- Understand indications, risks, contraindications and limitations/pitfalls of allergy tests
Provocation Testing
- Able to perform appropriate and adequate drug provocation test
- Have appropriate resuscitation facilities and training for drug provocation testing
- Counsel and manage patients following positive drug allergy testing
- Delabelling and counselling of patients following negative provocation testing
Acute management
- Recognize the signs and symptoms of allergic reactions
- Confident in the immediate management of anaphylaxis and allergic reactions
- Knowledgeable on diagnosis and management of severe cutaneous adverse reactions
(Competencies of the above should also be evidenced by achieving satisfactory outcomes in the AAAAA knowledge assessments)
Research and Quality Assurance
- Evidence of dedication toward research or research collaborations in drug allergy
(e.g. publication in peer-reviewed articles, joining drug allergy research networks)
- Regular auditing of all drug allergy assessments and outcomes with systems of continuous quality improvement
Advocacy and Education
- Evidence of participating in advocacy or public/professional education for drug allergy