Epidemiology and potential associated risk factors of drug-related problems in hospitalised children in the United Kingdom and Saudi Arabia

Rashed, Asia N; Neubert, Antje; Tomlin, Stephen; Jackman, John; Alhamdan, Hani; Shaikh, Adnan Al; Attar, Ahmed; Aseeri, Mohammed; Wilton, Lynda V.; Wong, Ian C. K.

doi:10.1007/s00228-012-1302-x

Cited by 64 publications

(147 citation statements)

References 29 publications

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“…This difference may be due to differences in hospital settings including composition of healthcare workers, training levels of prescribers, presence or absence of support system, and difference in the definition of DRPs. A higher incidence was reported in UK and the Kingdom of Saudi Arabia study with 45.2% incidence within the same population of pediatric patients [20]. From the total incidence identified in this study, the percentage of male patients with DRPs was higher than of female patients(54.4 vs. 45.6%), although the difference was not significant (COR 1.5, 95% CI 0.9, 2.6, P = 0.089), and this finding is in agreement with the Hong Kong study [19].…”

Section: Discussionmentioning

confidence: 93%

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

2017

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Background Although medications play a vital role in the cure, palliation, and inhibition of disease, they also expose patients to drug-related problems (DRPs). DRPs are common in hospitalized patients. Specifically, pediatrics population are easily affected by DRPs, as dynamic and kinetic behaviors of drugs in this population are usually different than in adults. Objectives To assess the prevalence of DRPs and associated factors in a pediatric setting in Ethiopia. Setting Pediatric ward of Zewditu Memorial Referral Hospital, Addis Abbeba, Ethiopia. Methods A cross-sectional study was conducted on 285 randomly selected patients. Data were obtained through review of physician medication orders and patient files. The prevalence and type of DRPs were studied and documented using the Pharmaceutical Care Network Europe Foundation classification system. The results were summarized using descriptive statistics including frequency, mean, and standard deviation. To identify the independent predicators of DRPs, logistic regression analysis was run and a P value ≤0.05 was considered as statistically significant. Main outcome measure DRPs, types of DRPs, drugs that are frequently involved in DRPs, and factors associated with DRPs. Main outcome measure Number of DRPs. Results Of the 1055 medication orders reviewed, a total of 106 DRPs were identified in 90 patients. This gives an overall rate of drug-related problems of 31.57%. The most frequently identified DRPs were dosing problems, with dose too low being 34.9% and dose too high being 7.5%. This was followed by drug–drug interactions(38.67%) and adverse drug reactions (8.49%). The number of prescribed drugs (AOR 2.3, 95% CI 1.3–4.3, P = 0.007) and total number of disease conditions (AOR4.8, 95% CI 1.9, 12.1, P = 0.001) were potential risk factors for occurrence of DRPs. Conclusion The present study demonstrated that DRPs were common at the pediatric ward of Zewditu Memorial Referral Hospital and that it needs great attention. The most frequently identified DRPs were dosing problems, followed by drug–drug interactions and adverse drug reaction. Poly-pharmacy and number of disease conditions have been identified as important risk factors for occurrence of DRPs. The investigators recommend establishing a system for reporting DRPs in the pediatric ward of the hospital as it may facilitate appropriate measures for prospective interventions, such as training the healthcare team, as well as detail precautions to be followed by the practitioners. In addition to this, improving communication between the healthcare team members such as physicians, pharmacists, nurses, and other healthcare workers in the hospital is recommended.

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Section: Discussionmentioning

confidence: 93%

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

2017

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“…Since the last decade, the multifaceted collaboration between Pediatricians, Critical Care Physicians and Clinical Pharmacists was endorsed by the American Academy of Pediatrics,5 American College of Clinical Pharmacy and many studies in the field 59 …”

Section: Introductionmentioning

confidence: 99%

“…Despite the well-stablished importance5 - 9 of CPS to children and adolescents, in the last years, Brazil has started the implementation of single experiences around the country, especially for PICU patients, which has led to interesting but under reported results.…”

Section: Introductionmentioning

confidence: 99%

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Okumura

Silva

Comarella

2016

Revista Paulista de Pediatria (English Edition)

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Objective:Clinical Pharmacy Services (CPS) are considered standard of care and is endorsed by the Joint Commission International, the American Academy of Pediatrics, and the American College of Clinical Pharmacy. In Brazil, single experiences have been discreetly arising and the importance of these services to children and adolescents care has led to interesting results, but certainly are under reported. This short report aims to discuss the effect of implementing a bedside CPS at a Brazilian Pediatric Intensive Care Unit (PICU).Methods:This is a cross-sectional study conducted in a 12 bed PICU community hospital, from Campo Largo/Brazil. Subjects with<18 years old admitted to PICU were included for descriptive analysis if received a CPS intervention.Results:Of 53 patients accompanied, we detected 141 preventable drug-related problems (DRPs) which were solved within clinicians (89% acceptance of all interventions). The most common interventions performed to improve drug therapy included: preventing incompatible intravenous solutions (21%) and a composite of inadequate doses (17% due to low, high and non-optimized doses). Among the top ten medications associated with DRPs, five were antimicrobials. By analyzing the correlation between DRPs and PICU length of stay, we found that 74% of all variations on length of stay were associated with the number of DRPs.Conclusions:Adverse drug reactions due to avoidable DRPs can be prevented by CPS in a multifaceted collaboration with other health care professionals, who should attempt to use active and evidence-based strategies to reduce morbidity related to medications.

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“…DRPs may lead to additional complications that may lead to significant morbidity or mortality, prolonged hospitalization, and increased health care expenditure. Several problems and causes of DRPs in T2DM patients with hypertension and factors influencing will be reported in the study 5 . To date, poly pharmacy (≥ 5 concurrent medications), age status (≥ 65 years old), multiple medical conditions and renal impairment have been shown to be the most causing influencing factors 13 .…”

Section: Introductionmentioning

confidence: 99%

Impact of Medication and Psychological Behavior Assessment by Community Pharmacists in Type 2 Diabetes Mellitus Patients After Hospital Stay

Gangwar¹,

Parimalakrishnan²,

Monisha³

et al. 2014

Int. Res. J. Pharm.

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Drug related problem (DRPs) is a key factor which will affect the outcome of therapy and safety. The aim of the present study is to assess the DRPs in T2DM patients and psychological aspects of patients by community pharmacists to observe the rate of DRP. Prospective randomized controlled intervention study involved T2DM patients and conducted in two community pharmacies at Kanpur, Uttar Pradesh, India from January 2012 to December 2012. The assessment of DRPs was based on the PCNE. Changes in HBA1C, LDL, BP, foot examinations, changes medical and medication utilization were studied. Using as control group, received usual care, and interventional group provided, intervened with use of the STG. Researcher provided the knowledge to community pharmacists and patients. Baseline and interventional data were collected at 0,3,6,9 and 12 months. Over 12 month study, participants' average HBA1C reduced from 8.9 % at initial visit to 7.5 %. During this time, the eye examination rate was raised from 31 % to 48 %, and the foot examination rate was raised from 35 % to 50 %. It may be concluded that the intervention of pharmacists showed very less significant influence on any of the intermediate health outcomes in T2DM.

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Epidemiology and potential associated risk factors of drug-related problems in hospitalised children in the United Kingdom and Saudi Arabia

Cited by 64 publications

References 29 publications

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

Assessment of drug-related problems in pediatric ward of Zewditu Memorial Referral Hospital, Addis Ababa, Ethiopia

Relation between safe use of medicines and Clinical Pharmacy Services at Pediatric Intensive Care Units

Impact of Medication and Psychological Behavior Assessment by Community Pharmacists in Type 2 Diabetes Mellitus Patients After Hospital Stay

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