Pediatric prescription pick-up rates after ED visits

Kajioka, Eric H.; Itoman, Erick M.; Li, M. Lily; Taira, Deborah A.; Li, Gaylyn G.; Yamamoto, Loren G.

doi:10.1016/j.ajem.2004.10.015

Cited by 49 publications

(43 citation statements)

References 20 publications

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“…It is also possible that younger age alone contributes to parental sense of urgency. Similar to the study by Kajioka et al, 9 we found that prescription filling was more likely for boys. We also identified a significant association with race/ethnicity.…”

Section: Discussionsupporting

confidence: 81%

“…9,12,13,16 Our study reinforces the importance of nondemographic factors on medication adherence. Specifically, electronic prescribing increased the likelihood that a prescription would be filled.…”

Section: Discussionsupporting

confidence: 59%

“…10 Ekedahl and Månsson' s study 15 included children, but the number of children was unclear. In a study of unfilled prescriptions for children seen in the ED, Kajioka et al 9 reported an increase in filling in the 0-to 3-year-old age group within 20 days. Their data were limited to "highurgency" prescriptions.…”

Section: Discussionmentioning

confidence: 99%

“…[5][6][7] Studies from pediatric EDs demonstrate rates of unfilled prescriptions from 7% based on survey data 8 to 35% by using claims data. 9 Primary medication nonadherence also occurs in a primary care setting. Beardon et al 10 used claims data to demonstrate that 5.2% of all prescriptions, and 6.8% of prescriptions for children, were unfilled in a UK family practice.…”

mentioning

confidence: 99%

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Unfilled Prescriptions in Pediatric Primary Care

2012

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WHAT'S KNOWN ON THIS SUBJECT: Filling a prescription is the first step in medication adherence. Unfilled prescriptions are a documented component of nonadherence in adult and pediatric emergency departments and family practices. No one has reported the proportion of unfilled prescriptions in pediatric primary care. WHAT THIS STUDY ADDS:This study identifies the proportion of unfilled prescriptions in a large sample of primary care pediatric patients. It describes clinical and demographic factors associated with prescription filling and suggests that electronic prescribing may improve adherence. abstract BACKGROUND AND OBJECTIVES: Filling a prescription is the important first step in medication adherence, but has not been studied in pediatric primary care. The objective of this study was to use claims data to determine the rate of unfilled prescriptions in pediatric primary care and examine factors associated with prescription filling. METHODS:This retrospective observational study of pediatric primary care patients compares prescription data from an electronic medical record with insurance claims data. Illinois Medicaid provided claims data for 4833 patients who received 16 953 prescriptions during visits at 2 primary care sites over 26 months. Prescriptions were compared with claims to determine filling within 1 day and 60 days. Clinical and demographic variables significant in univariate analysis were included in logistic regression models. RESULTS:Patients were 51% male; most (84%) spoke English and were African American (38.7%) or Hispanic (39.1%). Seventy-eight percent of all prescriptions were filled. Among filled prescriptions, 69% were filled within 1 day. African American, Hispanic, and male patients were significantly more likely to have filled prescriptions. Younger age was associated with filling within 1 day but not with filling within 60 days. Prescriptions for antibiotics, from one of the clinic sites, from sick/follow-up visits, and electronic prescriptions were significantly more likely to be filled. CONCLUSIONS:More than 20% of prescriptions in a pediatric primary care setting were never filled. The significant associations with clinical site, visit type, and electronic prescribing suggest system-level factors that affect prescription filling. Development of interventions to increase adherence should account for the factors that affect primary adherence. Pediatrics 2012;130:620-626 AUTHORS:

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Section: Discussionsupporting

confidence: 81%

Section: Discussionsupporting

confidence: 59%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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Unfilled Prescriptions in Pediatric Primary Care

2012

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“…One intriguing benefi t to the hospitalist is the potential to dispense a second dose in the hospital before discharge, thereby ensuring a high degree of compliance and obviating the need for a prescription, which as many as 33% to 65% of pediatric patients fail to have fi lled. 39,40 A prospective, randomized controlled trial would be useful in evaluating these issues.…”

Section: Discussionmentioning

confidence: 99%

Is Dexamethasone an Effective Alternative to Oral Prednisone in the Treatment of Pediatric Asthma Exacerbations?

Meyer

Riese

Biondi

2014

Hospital Pediatrics

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Background: A short course of systemic corticosteroids is an important therapy in the treatment of pediatric asthma exacerbations. Although a 5-day course of oral prednisone or prednisolone has become the most commonly used regimen, dexamethasone has also been used for a shorter duration (1–2 days) with potential for improvement in compliance and palatability. We reviewed the literature to determine if there is sufficient evidence that dexamethasone can be used as an effective alternative in the treatment of pediatric asthma exacerbations in the inpatient setting. Methods: A Medline search was conducted on the use of dexamethasone in the treatment of asthma exacerbations in children. The studies selected were clinical trials comparing the efficacy of dexamethasone with prednisone. Meta-analysis was performed examining physician revisitation rates and symptomatic return to baseline. Results: Six completed pediatric clinical trials met the inclusion criteria. All of the pediatric trials found that prednisone is not superior to dexamethasone in treating mild to moderate asthma exacerbations. Meta-analysis demonstrated homogeneity between the dexamethasone and prednisone groups when examining symptomatic return to baseline and unplanned physician revisits after the initial emergency department encounter. Some studies found potential additional benefits of dexamethasone, including improved compliance and less vomiting. Conclusions: The current literature suggests that dexamethasone can be used as an effective alternative to prednisone in the treatment of mild to moderate acute asthma exacerbations in children, with the added benefits of improved compliance, palatability, and cost. However, more research is needed to examine the role of dexamethasone in hospitalized children.

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