Abstract
BACKGROUND: Nonsteroidal anti-inflammatory drug (NSAID) hypersensitivity reactions are common and can lead to medication avoidance and health anxiety. OBJECTIVE: Despite their frequency, the specific impact of NSAID hypersensitivity on quality of life in a US population remains underexplored. We therefore aimed to explore this impact. METHODS: We conducted a cross-sectional survey to evaluate drug-related quality of life using the validated Drug Hypersensitivity Quality of Life Questionnaire, a 15-item tool measuring the impact of drug allergy on quality of life. The study population consisted of adults with self-reported NSAID allergy from January 2014 to January 2024 at a tertiary academic medical center and a county hospital in Dallas, Texas. RESULTS: In total, 154 adults had NSAID allergy documented in their electronic medical record. All 154 individuals were contacted, and of the 70 who were reached, 61 completed the survey (79% female, 61% White, 38% Black, and 28% Hispanic). The majority (87%) reported prior NSAID reactions, with common symptoms including dyspnea (52%) and rash (33%). Their mean Drug Hypersensitivity Quality of Life Questionnaire score was 42.87 plus or minus 15.52, indicating a substantial burden on quality of life. Top concerns included fear of receiving an allergy-provoking medication during an emergency situation and the desire for allergist input before medical use. Lifestyle limitations were reported as minimal. Comorbid aspirin-exacerbated respiratory disease and chronic spontaneous urticaria were reported in 34% and 20% of the participants, respectively. CONCLUSIONS: NSAID hypersensitivity is associated with significant quality of life burden in a US population, driven by anxiety around medication safety. The study findings support the need for comprehensive allergy evaluation and patient education, as well as a need for the consideration of delabeling strategies regarding drug-related quality of life.