Descriptive study of discharge medications in pediatric patients

Abstract

Background: Limited studies have evaluated medications in children discharged from hospitals. Knowledge of the number of medications and dosage forms could provide a baseline to establish a medication discharge prescription program. Objectives: To identify the median number of discharge prescriptions per patient. Secondary objectives included an evaluation of the dosage formulations and frequency, and comparisons of the prevalence of unrounded medication doses between service type (medical vs surgical) and physician provider level (trainees vs attendings). Methods: This retrospective study included children <18 years receiving >1 discharge prescription during 4 selected months over a 1-year time frame. Comparisons were made via Pearson’s chi-square tests, Fisher’s Exact tests, and Kruskal–Wallis nonparametric rank tests as appropriate with a priori p value of <0.05. Results: A total of 852 patients were evaluated, with most (78.8%) on a medical service. The median (interquartile range) number of new medications at discharge was 2 (1–3), with the median total number of discharge medications of 3 (2–6). There was no difference in the net change of the median number of home medications stopped and new medications started between service types. The majority (72.2%) received >1 oral liquid medications. There was no difference in prescribing rates per service type and provider level. There was a difference in the number of unrounded doses between trainees versus attendings, 17.8% versus 9.5%, p = 0.048. Conclusion: Patients were discharged on a median of three medications, and most received >1 oral liquid medications. These data can be used to target children who would benefit from medication discharge prescription programs.

Syntax Error: Variations in the Verbiage of Prescription Labels for Pediatric Liquid Medications

“…This may play a role in the syntax or lack of verbs found in the prescriptions in this study. This study did not measure physician counseling, which plays a role in preventing medication injuries [ 13 , 14 ].…”

Do pediatric oral suspension acetaminophen and ibuprofen product labeling and online resources facilitate intended use?

“…In their comprehensive review of pediatric discharge medications at an a large academic medical center, Nguyen and colleagues found that 12.5% of all liquid medications were unrounded. 12 As such, liquid medication dosing should be rounded to facilitate improved accuracy (e.g., 1.875 mL could be listed as 1.9 mL) and administration of both OTC products and prescriptions.…”

Parents and caregivers experience in managing children’s medicines after discharge from a New Zealand hospital

“…This study generates important information for quality improvement and a standardised paediatric discharge process is recommended to improve parents/caregivers understanding and management of their children's medications at home. 26 This discharge process will need to include the relevant HCPs including pharmacists 27 to work collaboratively and consistently using health literacy communication strategies such as (i) providing written medication information for better recall of information, (ii) using teach-back techniques to see if parents/caregivers have understood instructions, (iii) avoiding giving too much information all at once, (iv) using interpreters for those with a language barrier, and (v) providing measuring equipment for improved adherence and correct administration of medication at home. 12,26…”

“…• Other (please specify) 27. What language would you like to receive information about your child's medicines in?…”