Epidemiology of medication-related problems in children with kidney disease

Abstract

BackgroundMedication-related problems (MRPs) are the undesirable effects of pharmacotherapy that can potentially lead to harm. The epidemiology of MRPs in paediatric renal patients is unknown. We aimed to characterise MRPs in this population at two tertiary care hospitals in the UK.MethodsPrescription charts for children (≤18 years) were reviewed to identify MRPs, and characterised using a specific proforma with a standard operational definition. MRP predictors were evaluated by logistic regression and severity was assessed using a validated scale.ResultsTwo hundred and sixty-seven MRPs were identified from 266 prescription chart reviews. The incidence was 51.2 % (203 MRPs, 166 charts; 95 % CI 43.2–60.6 %) of hospitalised patients and 32 % (64 MRPs, 100 charts; 95 % CI 22.9–41.1 %) in outpatients. The number of prescribed medications was the only independent predictor during inpatient treatment (OR 1.06, 95 % CI 1.02–1.10, p = 0.002) with no significant predictors identified at outpatient clinics. The severity level of the MRPs was minor: 53.9 %, (144 out of 267); or moderate: 46.1 %, (123 out of 267). Sub-optimal drug effect was the predominant MRP (inpatient: 68 %; outpatient: 39 %). Prescribing error and patients' medicine-taking behaviour were the main contributory factors. The majority of the MRPs in the inpatient setting were resolved.ConclusionMany factors are associated with MRPs in children; the associations are cumulative and interdependent. Investment in preventive strategies and extending the support from the acute health care setting into the community are invaluable for optimising pharmacotherapy.

Drug-Related Problems in Cardiac Neonates Under Intensive Care

“…This result was higher than what has been found in international and Brazilian studies conducted in general pediatrics, in which DRP ranged from 20 to 70%. [16][17][18][19][20][21] The result, however, is lower than what was observed in the study by Sabry et al, 11 in which all 60 cardiopathic children evaluated were exposed to DRP while in an Egyptian hospital. However, it is worth noting that local specificities, population characteristics, methods of identification and classification of DRPs and the follow-up time of the study make these comparisons difficult.…”

“…22,23 Similar to pediatric studies, antimicrobials were the group of drugs most involved in GRP. [16][17][18][19][20]24,25 Some authors state that the risk of adverse events related to each drug is directly associated with the frequency of prescription. 24,25 However, similar to the findings of Blix et al, 26 in our study the most involved medications were not necessarily the most prescribed, showing that the risk of damage is related to the chemical and pharmacological characteristics of the medications, as well as patient characteristics.…”

“…27,28 Pharmacists intervened in 17 out of every 20 DRPs identified, and virtually all of the proposed interventions were accepted by doctors and nurses, a finding also seen in other studies. 18,19,21 Thus, the broad support provided by the NICU professional team demonstrates the need to strengthen clinical pharmacy services as one of the main strategies for prevention and reduction of DRP.…”

Drug Therapy Problem and its Contributing Factors among Pediatric patients with Infectious Diseases admitted to Jimma University Medical Center, South West Ethiopia: Prospective observational study

“…In the present study (27.52%) of the DTPs was found to be dose too low. This was in line with a study done in London (21.7%), Canada (19%) and Egypt (21.09%) (25,29,45). Dose too high was found to be (10.95%) in the present study which was lower than the study done in Hong Kong 19.3% (22).…”

“…Other findings also reported that DTPs were more frequent in males than in female. But, it was statistically insignificant (22,35,45). This indicated that drug therapy problems could be occurred irrespective of the sex.…”