Allergy Delabelling Beyond the Specialist Clinic: Multidisciplinary and Opportunistic Models Across Healthcare Settings

Allergy delabelling, the systematic correction of inaccurate or outdated allergy labels in patient records. has become a central priority in antibiotic stewardship, patient safety, and healthcare efficiency. It is estimated that up to 10% of hospitalised patients carry a drug allergy label, yet the vast majority are found tolerant on formal evaluation. Beyond drug allergies, incorrect labels for food allergens, vaccines, and biological therapies continue to expose patients to suboptimal care, elevated healthcare costs, and avoidable clinical risk. Alongside delabelling, allergen immunotherapy and rapid desensitisation protocols have expanded as evidence-based strategies for achieving long-term or short-term tolerance in patients with confirmed allergy, transforming how allergy is identified, evaluated, and managed across modern healthcare systems.

Traditionally, both delabelling and immunotherapy have been delivered exclusively in specialist allergy clinics, limiting access and scalability. A rapidly growing body of evidence from 2024 and 2025 challenges this paradigm. Pharmacist-led and nurse-facilitated drug allergy evaluation programmes, hospitalist-driven inpatient delabelling initiatives, and opportunistic strategies applied during vaccination visits, oncology encounters, or surgical pre-assessments have demonstrated safety and feasibility in non-specialist settings. Multidisciplinary models (integrating pharmacists, nurses, primary care physicians, paediatricians, oncologists, and endocrinologists) are emerging as the scalable solution to close the gap between the high prevalence of allergy labels and the limited capacity of specialist allergy services. Nevertheless, evidence on workforce training, patient selection, outcome measurement, and system-level implementation remains fragmented, underscoring the need for dedicated evidence synthesis in this area.

This Research Topic aims to consolidate and advance the evidence base for allergy delabelling, desensitisation, and immunotherapy delivered through multidisciplinary and opportunistic models beyond the specialist allergy clinic. It seeks to identify best-practice frameworks applicable across diverse clinical environments, evaluate the roles of non-allergy healthcare professionals in safe allergy evaluation and management, and examine how innovative therapeutic approaches, including biologic-assisted immunotherapy and rapid desensitisation protocols, can be integrated into multidisciplinary care pathways across all age groups and clinical contexts. Key objectives include mapping the workforce competencies and models of care that enable non-specialist delivery; evaluating outcomes of inpatient, opportunistic, and community-based delabelling programmes; and assessing how emerging therapies can be applied safely beyond tertiary allergy centres.

To gather multidisciplinary approaches to allergy delabelling, desensitisation, and immunotherapy, we welcome articles addressing, but not limited to, the following themes:
- Pharmacist-led, nurse-facilitated, and hospitalist-driven drug allergy delabelling programmes in inpatient and outpatient settings
- Inpatient and point-of-care delabelling strategies for penicillin, beta-lactam, and other drug allergies
- Opportunistic delabelling during vaccination campaigns, surgical pre-assessments, oncology visits, or primary care encounters
- Rapid desensitisation protocols in non-allergy clinical settings, including endocrinology, oncology, and rheumatology
- Biologic-assisted allergen immunotherapy for food and drug allergy in paediatric and adult populations
- Multidisciplinary team models for immunotherapy and desensitisation delivery outside tertiary allergy centres
- Workforce training, competency frameworks, and safety protocols for non-specialist allergy evaluation
- Patient selection and risk stratification tools for non-specialist-led delabelling and desensitisation
- Delabelling and immunotherapy in special populations: children, cancer patients, pregnant women, and patients with complex comorbidities
- Health-economic analyses of expanding delabelling programmes to inpatient and non-specialist settings
- Implementation science approaches to scaling multidisciplinary delabelling at health-system level
- Standardised protocols and decision-support tools facilitating non-specialist allergy management

We welcome all article types, including original research, systematic reviews, mini-reviews, perspectives, clinical case studies, and FAIR² Data Articles.

Article types and fees

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• ... View all formats

Articles that are accepted for publication by our external editors following rigorous peer review incur a publishing fee charged to Authors, institutions, or funders.

Article types

This Research Topic accepts the following article types, unless otherwise specified in the Research Topic description:

• Brief Research Report
• Case Report
• Classification
• Clinical Trial
• Community Case Study
• Data Report
• Editorial
• FAIR² Data
• General Commentary
• Hypothesis and Theory
• Methods
• Mini Review
• Opinion
• Original Research
• Perspective
• Policy and Practice Reviews
• Policy Brief
• Review
• Study Protocol
• Systematic Review
• Technology and Code

Keywords: Allergy delabelling, Multidisciplinary care, Drug allergy, Desensitisation, Immunotherapy, Inpatient delabelling, Pharmacist-led, Opportunistic delabelling, Food allergy, Non-specialist healthcare, Paediatric allergy, Rapid desensitisation

Important note: All contributions to this Research Topic must be within the scope of the section and journal to which they are submitted, as defined in their mission statements. Frontiers reserves the right to guide an out-of-scope manuscript to a more suitable section or journal at any stage of peer review.