A literature review to identify interventions to improve the use of medicines in children

Abstract

Although there is little evidence specific to paediatrics, the objectives and rationale of medication review could be expected to apply to chronic diseases in children. Issues such as polypharmacy, wastage, repeat prescriptions and medication problems could be similar. The benefits seen in adults may also occur in children, and medication review may possibly have a role in the management of medicines in children. There is an obvious role for pharmacists in ensuring the safety of over-the-counter medications and provision of information and education to parents, carers and adolescents. Evaluation and provision of necessary education and training to community pharmacists is needed, even in the most basic paediatric issues such as sugar-free medications. The evidence suggests that treatment compliance and adherence are generally lower in children than in adults, particularly in adolescents as they approach independence. Those with learning disabilities and infants are likely to be at risk of non-compliance, although little work has been done in these populations. Children and adolescents need appropriate parental and professional support in taking control of their medication and treatment. The management of medicines in school would appear to be far from ideal. Further research into school-based medicines education and outreach clinics would also be beneficial.

Graves’ Disease in Childhood: Advances in Management with Antithyroid Drug Therapy

“…More prolonged use of ATD (at least 2–4 years) in children than in adults may be required to achieve remission. Compliance is therefore an important issue in the management of these children and should be improved by educational strategies [28]. However, the inhibition of autoantibodies obtained on treatment is difficult to predict, probably because the treatment does not target B cells or autoantibodies directly.…”

Barriers to administering non-oral formulations in a paediatric population: A semi-structured interview study

“…Approximately 200 million prescriptions are issued annually for children and young people in the UK 15 (Costello et al, 2004). It has been estimated that 5 -10% of young people worldwide suffer from 16 chronic health conditions (Newacheck et al, 2000).…”

Self‐medication among children and adolescents in Germany: results of the National Health Survey for Children and Adolescents (KiGGS)

“…according to the package insert. Nevertheless, parents and adolescents may have insufficient knowledge about the medicines they use, which can lead to inappropriate drug use -even to serious, adverse drug effects among self-medicating children and adolescents [4]. For example, Reye syndrome is a life-threatening adverse reaction to aspirin in young children.…”

“…For example, Reye syndrome is a life-threatening adverse reaction to aspirin in young children. Many parents are unaware that aspirin should not be given to children <12 years old [4] and that it should be used very carefully or not at all in adolescents aged 12-16 years to avoid such serious adverse drug reactions [5].Furthermore, very few paediatric OTC drugs have been adequately tested for safety and efficacy among child populations; the dosages of most paediatric OTC drugs have been extrapolated from adult clinical and pharmacological data. Use of OTC drugs in children has been linked to serious adverse cardiovascular events due to the inadvertent overdosing of CCMs [6], for example.…”