Evaluating the Effect of Drug Provocation Tests on Anxiety and Hopelessness Levels
Abstract
1. Introduction
2. Materials and Methods
2.1. Study Design and Study Population
2.2. Demographic and Clinical Characteristics of Patients
2.3. Classification of Drug Hypersensitivity Reactions
2.4. Administration of Drug Provocation Tests and Management of Patients
2.5. Assessment of Anxiety Level
2.6. Assessment of Hopelessness Level
2.7. Statistical Analysis
3. Results
3.1. Demographic and Clinical Characteristics of the Patients
3.2. Evaluation of Drug Provocation Test Results
3.3. Assessment of Anxiety and Hopelessness Level
3.4. Evaluation of the Changes in Beck Hopelessness Scale, STAI-S and STAI-T Scores
3.5. Evaluation of Patients’ Use of Alternative Safe Medicines
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
DHR | Drug Hypersensitivity Reaction |
DPT | Drug provocation tests |
NSAID | Nonsteroidal anti-inflammatory drug |
OFC | Oral Food Challenge |
PPI | Proton pump inhibitors |
STAI | The State–Trait Anxiety Inventory |
STAI-S | The State–Trait Anxiety Inventory – State |
STAI-T | The State–Trait Anxiety Inventory – Trait |
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Characteristics Values | |
---|---|
Female/Male, n (%) | 60 (75.9)/19 (24.1) |
Age (y), mean | 43.61 ± 11.39 |
Female | 44.2 ± 10.8 |
Male | 41.5 ± 13.1 |
Education level, n (%) | |
Primary school | 20 (25.3) |
Secondary school | 10 (12.7) |
High school | 18 (22.8) |
University | 31 (39.2) |
Occupation, n (%) | |
Not employed | 34 (43) |
Employed | 38 (48.1) |
Retired | 5 (6.3) |
Student | 2 (2.5) |
Concomitant allergic disease, n (%) | 34 (43) |
Allergic rhinitis | 8 (10.1) |
Asthma | 26 (32.9) |
Chronic urticaria | 10 (12.6) |
Venom hypersensitivity | 1 (1.2) |
Food hypersensitivty | 2 (2.5) |
Nasal polyp | 1 (1.2) |
Concomitant other diseases, n (%) | 40 (50.6) |
Psychiatric disease | 4 (5.1) |
Suspected culprit drug, n (%) | |
Antibiotics | 50 (62.5) |
Beta lactam | 40 (50.6) |
Quinolone | 7 (8.9) |
Macrolide | 13 (16.5) |
Other antibiotics | 11 (13.9) |
NSAIDs, | 42 (53.2) |
Other drugs | 44 (55.7) |
Duration since the last drug hypersensitivity reaction, n | |
<6 months | 37 (46.8) |
≥6 months | 42 (53.2) |
Type of symptoms of the initial drug hypersensitivity reactions, n (%) | |
Wheal | 63 (79.7) |
Angioedema | 49 (62) |
Dyspnea | 23 (29.1) |
Anaphylaxis | 12 (15.2) |
Gastrointestinal symptoms | 16 (20.3) |
Cardiovascular symptoms | 10 (12.7) |
Neurological symptoms | 19 (24.1) |
Maculopapular exanthema | 7 (8.9) |
Other symptoms | 9 |
Grade of initial drug hypersensitivty reactions, n (%) | 72 (91.1) |
Grade 1 | 30 (38) |
Grade 2 | 4 (5.1) |
Grade 3 | 27 (34.2) |
Grade 4 | 1 (1.3) |
Grade 5 | 14 (17.7) |
Variables Values | |
---|---|
Drugs | |
Antibiotics | 54 (68.3) |
NSAID | 42 (53.2) |
Local anesthetic drugs | 9 (11.4) |
PPI | 2 (2.5) |
Other drugs | 22 (27.8) |
Presence of reaction that developed during DPT, n (%) | |
Yes | 15 (19) |
No | 64 (81) |
Reactions that developed during a positive DPT, n (%) | |
Pruritus | 3 (3.7) |
Erythema | 4 (5) |
Wheal | 9 (11.3) |
Angioedema | 4 (5) |
Nause | 1 (1.3) |
Nasal congestion | 1 (1.3) |
Headache | 1 (1.3) |
Stomachache | 1 (1.3) |
Hypotension | 1 (1.3) |
Maculopapular eruption | 4 (5) |
Grade of reactions that developed during a positive DPT, n (%) | |
Grade 1 | 10 (66) |
Grade 2 | 2 (13.3) |
Grade 3 | 1 (6.6) |
Grade 4 | None |
Grade 5 | 1 (6.6) |
n | Min. | Max. | 25th | 50th (Median) | 75th | Z * | p | Effect Size | |
---|---|---|---|---|---|---|---|---|---|
Beck Scale Before DPT | 79 | 1.00 | 15.0 | 2.0 | 4.0 | 6.0 | −4.014 | 0.000 | 0.452 |
After DPT | 79 | 0.0 | 18.0 | 1.0 | 3.0 | 4.0 | |||
STAI-S Before DPT | 79 | 19 | 70 | 27.0 | 37.0 | 44.0 | −5.511 | 0.000 | 0.62 |
After DPT | 79 | 16 | 65 | 24.0 | 30.0 | 37.0 | |||
STAI-T Before DPT | 79 | 26 | 63 | 37.0 | 43.0 | 49.0 | −6.157 | 0.000 | 0.693 |
After DPT | 79 | 20 | 66 | 28.0 | 36.0 | 42.0 |
n | Scale Score | Test Value p-Value | |||
---|---|---|---|---|---|
Decreased Group (n = 67) | Increased Group (n = 12) | Effect Size | |||
Age | 79 | 43.24 ± 11.72 | 45.67 ± 9.48 | −0.786 Ω 0.442 | 0.246 |
Gender Female Male | 60 19 | 50 (83.3%) 17 (89.5%) | 10 (16.7%) 2 (10.5%) | 0.422 ¥ 0.516 | 0.073 |
Education level Primary and secondary school High school and university | 30 49 | 25 (83.3%) 42 (85.7%) | 5 (16.7%) 7 (14.3%) | - 0.507 ¶ | - |
Occupation Employed and student Retired and not employed | 40 39 | 32 (80.0%) 35 (89.7%) | 8 (20.0%) 4 (10.3%) | - 0.186 ¶ | - |
Concominant allergic disease Yes No | 34 45 | 27 (79.4%) 40 (88.9%) | 7 (20.6%) 5 (11.1%) | 1.350 ¥ 0.245 | 0.131 |
Concomitant other disease Yes No | 40 39 | 33 (82.5%) 34 (87.2%) | 7 (17.5%) 5 (12.8%) | 0.336 ¥ 0.562 | 0.065 |
Concomitant psychiatric disease Yes No | 4 75 | 3 (75%) 64 (85.3%) | 1 (25%) 11 (14.7%) | 0.315 ¥ 0.575 | 0.063 |
Grade of initial immediate reaction, median (range) | 79 | 3 (1–5) 2.5 ± 1.4 | 3 (1–5) 2.7 ± 1.6 | −0.499 § 0.618 | 0.056 |
Presence of anaphylaxis Yes No | 12 67 | 10 (83.3%) 57 (85.1%) | 2 (16.7%) 10 (14.9%) | 0.024 ¥ 0.877 | 0.017 |
Type of initial reaction Non-immediate Immediate | 7 72 | 7 (100%) 60 (83.3%) | 0 (0%) 12 (16.7%) | 1.376 ¥ 0.241 | 0.132 |
Presence of reaction that developed during DPT Yes No | 15 64 | 9 (60.0%) 58 (90.6%) | 6 (40.0%) 6 (9.4%) | 8.847 ¥ 0.003 | 0.335 |
n | Safe Drug Use Status | Test Value p-Value | |||
---|---|---|---|---|---|
Took Alternative Drug (n = 37) Group A | Did Not Take Alternative Drug (n = 6) Group B | Effect Size | |||
Age | 43 | 42.49 ± 11.36 | 47.50 ± 9.60 | −1.154 Ω 0.284 | 0.508 |
Gender Female Male | 30 13 | 25 (83.3%) 12 (92.3%) | 5 (16.7%) 1 (7.7%) | 0.608 ¥ 0.435 | 0.119 |
Education level Primary and secondary school High school and university | 21 22 | 17 (81.0%) 20 (90.9%) | 4 (19.0%) 2 (9.1%) | - 0.309 ¶ | - |
Occupation Employed and student Retired and not employed | 20 23 | 17 (85.0%) 20 (87.0%) | 3 (15.0%) 3 (13.0%) | - 0.597 ¶ | - |
Concomitant allergic disease Yes No | 19 24 | 14 (73.7%) 23 (95.8%) | 5 (26.3%) 1 (4.2%) | 4.333 ¥ 0.037 | 0.317 |
Concomitant other disease Yes No | 20 23 | 17 (85.0%) 20 (87.0%) | 3 (15.0%) 3 (13.0%) | 0.034 ¥ 0.853 | 0.028 |
Concomitant psychiatric disease Yes No | 1 42 | 1 (%100) 36 (85.7%) | 0 (%0) 6 (14.3%) | 0.166 ¥ 0.684 | 0.062 |
Grade of initial reactions, median (range) | 43 | 3 (1–5) | 2 (1–3) | −1.005 § 0.315 | 0.153 |
Presence of anaphylaxis Yes No | 5 38 | 4 (80.0%) 33 (86.8%) | 1 (20.0%) 5 (13.2%) | 0.172 ¥ 0.678 | 0.063 |
Type of initial reaction Immediate Non-immediate | 38 5 | 5 (%100) 32 (84.2%) | 0 (%0) 6 (15.8%) | 0.917 ¥ 0.338 | 0.146 |
Presence of reaction that developed during DPT Yes No | 8 35 | 6 (75.0%) 31 (88.6%) | 2 (25.0%) 4 (11.4%) | 0.999 ¥ 0.318 | 0.152 |
1st Beck scale score | 43 | 4 (1–11) | 4 (2–14) | −0.907 § 0.365 | 0.138 |
2nd Beck scale score | 43 | 3 (0–16) | 6 (2–17) | −2.561 § 0.01 | 0.391 |
1st STAI-S score | 43 | 35.59 ± 10.12 | 34.67 ± 12.20 | 0.177 Ω 0.865 | 0.078 |
1st STAI-T score | 43 | 41.89 ± 8.14 | 48.0 ± 10.31 | −1.382 Ω 0.216 | 0.608 |
2nd STAI-S score | 43 | 28.73 ± 8.88 | 37.67 ± 10.40 | −1.990 Ω 0.092 | 0.876 |
2nd STAI-T score | 43 | 34.43 ± 9.59 | 47.17 ± 10.66 | −2.750 Ω 0.031 | 1.21 |
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© 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Vural Solak, G.T.; Aksu, K.; Yağdıran, M.; Dindar Çelik, F.; Akkale, Ö.; Telli, O.; Çelik Tuğlu, H.; Baştuğ İnan, N.B.; Göktürk, Ö.; Karahan, Y.; et al. Evaluating the Effect of Drug Provocation Tests on Anxiety and Hopelessness Levels. Medicina 2025, 61, 1014. https://doi.org/10.3390/medicina61061014
Vural Solak GT, Aksu K, Yağdıran M, Dindar Çelik F, Akkale Ö, Telli O, Çelik Tuğlu H, Baştuğ İnan NB, Göktürk Ö, Karahan Y, et al. Evaluating the Effect of Drug Provocation Tests on Anxiety and Hopelessness Levels. Medicina. 2025; 61(6):1014. https://doi.org/10.3390/medicina61061014
Chicago/Turabian StyleVural Solak, Gürgün Tuğçe, Kurtuluş Aksu, Melis Yağdıran, Fatma Dindar Çelik, Özgür Akkale, Onur Telli, Hatice Çelik Tuğlu, Nur Betül Baştuğ İnan, Özge Göktürk, Yavuz Karahan, and et al. 2025. "Evaluating the Effect of Drug Provocation Tests on Anxiety and Hopelessness Levels" Medicina 61, no. 6: 1014. https://doi.org/10.3390/medicina61061014
APA StyleVural Solak, G. T., Aksu, K., Yağdıran, M., Dindar Çelik, F., Akkale, Ö., Telli, O., Çelik Tuğlu, H., Baştuğ İnan, N. B., Göktürk, Ö., Karahan, Y., & Solak, Y. (2025). Evaluating the Effect of Drug Provocation Tests on Anxiety and Hopelessness Levels. Medicina, 61(6), 1014. https://doi.org/10.3390/medicina61061014