International consensus validation of the POPI tool (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions) to identify inappropriate prescribing in pediatrics

Abstract

Discussion and conclusion This study highlights international consensus on prescription practice in pediatrics. The use of this tool in everyday practice could reduce the risk of inappropriate prescription. The impact of the diffusion of POPI tool will be assessed in a prospective multicentric study. 9 (2-9) 94.4 9 (3-9) 92.9 Rectal administration of paracetamol as a first-line treatment 8 (1-9) 78.9 8.5 (1-9) 85.7 The combined use of two NSAIDs 9 (1-9) 94.4 9 (7-9) 100 Opiates to treat migraine attacks 9 (3-9) 89.5 9 (8-9) 100 Omission of prescription Failure to give sugar solution to newborn babies and infants under four months old two minutes prior to venipuncture 9 (2-9) 88.9 9 (8-9) 100 Failure to give an osmotic laxative to patients being treated with morphine for a period of more than 48 hours 8 (2-9) 82.4 9 (8-9) 100 Urinary infections Inappropriate prescription Antibiotic prophylaxis following an initial infection without complications (except in the case of uropathy) 9 (1-9) 94.7 9 (9-9) 100 Antibiotic prophylaxis in the case of asymptomatic bacterial infection (except in the case of uropathy) 9 (1-9) 94.7 9 (8-9) 100 Vitamin supplements and antibiotic prophylaxis Inappropriate prescription Fluoride supplements prior to six months of age 9 (1-9) 94.7 9 (9-9) 92.9 Mosquitos Inappropriate prescription Citronella (lemon grass) essential oil 9 (1-9) 82.4 8.5 (1-9) 85.7 Anti-insect bracelets to protect against mosquitos and ticks 9 (1-9) 83.3 9 (1-9) 85.7 Ultrasonic pest control devices, vitamin B1, homeopathy, electric bug zappers, sticky tapes without insecticide 9 (1-9) 88.2 9 (1-9) 85.7 Omission of prescription Mosquito nets and clothes treated with pyrethroids 9 (1-9) 83.3 9 (1-9) 85.7 Digestive nausea, vomiting or gastroesophageal reflux problems Inappropriate prescription Metoclopramide 9 (3-9) 94.4 9 (3-9) 92.9 Domperidone 8 (2-9) 77.8 8.5 (3-9) 85.7 Oral administration of an intravenous proton pump inhibitor (notably by nasogastric tube) 9 (1-9) 94.7 9 (8-9) 100 Gastric antisecretory drugs to treat gastroesophageal reflux, dyspepsia, the crying of newborn babies (in the absence of any other signs or symptoms), as well as faintness in infants 9 (1-9) 94.7 9 (6-9) 92.9 9 (5-9) 94.4 9 (7-9) 100 Antibiotic treatment for a sore throat, without a positive rapid diagnostic test result, in children less than three years old 9 (1-9) 88.9 9 (5-9) 92.9 Antibiotics for-nasopharyngitis-congestive otitis-sore throat before three years of age-laryngitis-as a first-line treatment for acute otitis media showing few symptoms, before two years of age 9 (3-9) 82.4 9 (5-9) 92.9 Antibiotics to treat otitis media with effusion (OME), except in the case of hearing loss or if OME lasts for more than three months 9 (1-9) 84.2 9 (7-9) 100 Corticosteroids to treat acute suppurative otitis media, nasopharyngitis, or strep throat 9 (1-9) 94.7 9 (8-9) 92.9 Nasal or oral decongestant (oxymetazoline, pseudoephedrine, naphazoline, ephedrine, tuaminoheptane, phenylephrine) 9 (4-9) 82.4 9 (5-9) 92.9 H1-antagonists with sedative or atr...

Expert Consensus on a List of Inappropriate Prescribing after Prescription Review in Pediatric Units in Abidjan, Côte d’Ivoire

“…The final list obtained after consensus validation comprised 52 items, lower than the latest version of POPI (52 vs 103). 23 However it was higher than than for PIPc (52 vs 12). 25 …”

“…This rate was higher than that observed during validation of the latest version of the POPI tool (86.9% vs 70%). 23 It was, however, lower than that observed for validation of the PIMCheck tool (potentially inappropriate medication—patients in the internal medicine unit; 86.9% vs 100%). 38 …”

“…The methodology used for developing this list was quite original. It differed from those adopted for the development of the POPI 22 , 23 and PIPc tools. 25 In fact, the choice of items for these tools was made from a literature search on recommendations for the management of health problems related to local pediatric contexts.…”

“…Indeed, 20 and 14 experts participated, respectively, in the first and second rounds of a Delphi survey for the latest POPI tool. 23 For the PIPc tool, 25 15 experts participated in the two round.…”

“…To do that, we replaced experts’ missing answers from the second round with their answer in the first round. 23 …”