Retrospective study of irrational prescribing in French paediatric hospital: prevalence of inappropriate prescription detected by Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) in the emergency unit and in the ambulatory setting

Abstract

Background and objectivePediatrics: Omission of Prescription and Inappropriate prescription (POPI) is the first detection tool for potentially inappropriate medicines (PIMs) and potentially prescribing omissions (PPOs) in paediatrics. The aim of this study was to evaluate the prevalence of PIM and PPO detected by POPI regarding prescriptions in hospital and for outpatients. The second objective is to determine the risk factors related to PIM and PPO.DesignA retrospective, descriptive study was conducted in the emergency department (ED) and community pharmacy (CP) during 6 months. POPI was used to identify PIM and PPO.SettingRobert-Debré Hospital (France) and Albaret community pharmacy (Seine and Marne).ParticipantsPatients who were under 18 years old and who had one or more drugs prescribed were included. Exclusion criteria consisted of inaccessible medical records for patients consulted in ED and prescription without drugs for outpatients.Primary and secondary outcome measuresPIM and PPO rate and risk factors.ResultsAt the ED, 18 562 prescriptions of 15 973 patients and 4780 prescriptions of 2225 patients at the CP were analysed. The PIM rate and PPO rate were, respectively, 2.9% and 2.3% at the ED and 12.3% and 6.1% at the CP. Respiratory and digestive diseases had the highest rate of PIM.ConclusionThis is the first study to assess the prevalence of PIM and PPO detected by POPI in a paediatric population. This study assessed PIMs or PPOs within a hospital and a community pharmacy. POPI could be used to improve drug use and patient care and to limit hospitalisation and adverse drug reaction. A prospective multicentric study should be conducted to evaluate the impact and benefit of implementing POPI in clinical practice.

Assessment of prescribing in under-five pediatric outpatients in Nigeria: an application of the POPI (Pediatrics: Omission of Prescription and Inappropriate Prescription) tool

“…French Hospital where 2.9% had an inappropriate prescription and 2.7% had an omission of prescription [15] . A similar study done in the UK with a modified POPI tool had 32 out of a total of 400 prescriptions having either inappropriate prescriptions or omission of prescription [9] .…”

“…Potentially inappropriate prescriptions detect misprescribing and overprescribing while potentially inappropriate omissions detect underprescribing (omissions). The POPI had a consensus validation and has been validated with a retrospective study in a French Hospital and a community pharmacy setting Potentially inappropriate prescriptions and prescription omissions were detected in a hospital as 2.9% and 2.3% and the community pharmacy as 12.3% and 6.15% respectively [15]. The modified (UK) POPI has also been used in the English healthcare setting [9].…”

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

“…(Continued ) PLOS ONE The use of Saccharomyces boulardii in powder form, or in a capsule that has to be opened prior to ingestion, to treat patients with a central venous catheter or an immunodeficiency 9 (1)(2)(3)(4)(5)(6)(7)(8)(9) 89.5 9 (8-9) 100…”

“…The use of medication in pediatrics should be based on established recommendations from well-conducted clinical trials; however, in the absence of such trials, recommendations are often based on clinical experience. Misuse of medications can lead to adverse drug reaction (ADR) in pediatrics where the heterogeneous population undergoes important pharmacokinetics changes [3]. Incidence of ADR leading to hospital admission has been evaluated between 1.8% and 17.7% [4,5].…”

Analysis of the potential inappropriate use of medications in pediatric outpatients in China

“…It can result in severe morbidity and even mortality, so the choice and use of drugs in children should be paid more attention [4]. However, unlicensed and off-label prescriptions for children are common in many countries [5][6][7]. Monitoring the safety of medicine use in children is very important, especially the use of medicines outside the specifications described in the license (e.g., in terms of formulation, indications, contraindications, or age) constitutes off-label and off-license use, and these are a significant area of concern [8].…”