Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Feinstein, James A.; Dai, Dingwei; Zhong, Wenjun; Freedman, Jason L.; Feudtner, Chris

doi:10.1542/peds.2014-2015

Cited by 95 publications

(125 citation statements)

References 27 publications

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“…The present study was conducted with aim and objective to identify and evaluate the drug-drug interactions in paediatric outpatient department. In present study prevalence of DDIs were more in male as compare to females which was contrast to the study done by Feinstein J et al 10 showed equal occurrence of DDIs in male and female. It suggests that their prevalence could differ in individual gender.…”

Section: Discussioncontrasting

confidence: 99%

“…In present study, the overall prevalence of DDIs was 16 % out of all DDIs. Prevalence rate was lower in compare to studies conducted by Feinstein et al 10 and Qorraj-Bytyqi et al, 12 they reported that paediatric patients exposed to DDI were 49% and 23% respectively. DDI severity criteria enhances decision making ability by assessing risk versus benefit alternatives.…”

Section: Decrease Sedative Effectmentioning

confidence: 54%

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Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Mistry¹,

Gor²,

Ganguly³

2017

JYP

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Objective: To evaluate prevalence, types and severity of drug-drug interactions in paediatric outpatient department. Methods: An observational study was carried out in Shree Krishna Hospital (SKH), a tertiary care teaching hospital after obtaining Institutional Ethics Committee approval. In SKH outpatient prescriptions are uploaded on software "Solace" , and these online prescriptions were collected from IT department. Potential Drug-drug interactions (pDDIs) were identified by using Medscape drug interaction checker. The prescriptions were analysed for demographic characteristics, medical and detailed drug history. Drug-drug interactions (DDIs) were evaluated for total numbers, types and severity of DDIs. Result: Total 300 prescriptions with mean age 6.33 ± 5.24 years were analysed. Total 96 pDDIs were recorded. The prevalence of pDDI was 16%. Most common pDDI was Valproic acid + Acetaminophen. There were 61 (63.54%) DDIs of pharmacokinetic, 24 (25%) pharmacodynamic and 11 (11.46%) had an unknown mechanism. Out of all interactions, 41 (42.71%) were of minor, 48 (50%) were of moderate and 07 (7.29%) were of severe in nature. The number of drugs prescribed and the occurrence of DDIs were significantly associated. (p<0.001). This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

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Section: Discussioncontrasting

confidence: 99%

Section: Decrease Sedative Effectmentioning

confidence: 54%

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Mistry¹,

Gor²,

Ganguly³

2017

JYP

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“…Pasien dengan jumlah kunjungan rawat inap terbanyak diketahui memiliki riwayat komorbiditas lompokkan berdasarkan klasifikasi berikut, 16 a. Tingkat keparahan…”

Section: Hasilunclassified

“…Disebutkan bahwa terdapat minimal satu pasang kombinasi obat yang berpotensi menyebabkan interaksi pada 887 resep (49,7%) menggunakan perangkat lunak pemindai interaksi obat Micromedex Drug Reax®. 16 Berdasarkan data 214 kunjungan rawat inap pada periode Januari -Desember 2014, diperoleh 107 pasang jenis obat yang dapat menyebabkan PIOO dengan total frekuensi kejadian sebanyak 1000 kasus. Angka kejadian PIOO yang tinggi dikhawatirkan dapat berakibat buruk terhadap pasien.…”

Section: Pembahasanunclassified

“…6 Diskrepansi ini mungkin terjadi karena perbedaan klasifikasi tingkat keparahan PIOO pada perangkat lunak pemindai interaksi obat yang digunakan. 16 Untuk membatasi sensitivitas perangkat lunak dalam melakukan identifikasi PIOO, hanya kombinasi PIOO yang bersifat kontraindikasi, berat, atau sedang yang diikutsertakan dalam perhitungan prevalensi dan analisis faktor risiko. Berdasarkan hasil penelitian, diperoleh 24 pasang kombinasi obat yang dapat menyebabkan PIOO dengan tingkat keparahan ringan dengan total frekuensi kejadian sebanyak 56 kasus.…”

Section: Pembahasanunclassified

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Angka Kejadian dan Faktor yang Memengaruhi Potensi Interaksi Obat dengan Obat pada Pasien Leukemia Akut Anak yang Menjalani Rawat Inap

Fitriani

Mutiara

Malik

et al. 2016

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Latar belakang. Risiko terjadinya potensi interaksi obat dengan obat (PIOO) pada pasien leukemia akut akibat pemberian terapi multidrug cukup tinggi. Tujuan. Mengetahui angka kejadian dan faktor yang memengaruhi PIOO pada subjek penelitian. Metode. Penelitian dilakukan dengan metode potong lintang. Pengambilan data dilakukan secara retrospektif terhadap pasien leukemia akut pada anak yang menjalani rawat inap di RSCM pada Januari -Desember 2014. Identifikasi PIOO dilakukan menggunakan perangkat lunak Micromedex Drug Reax®. Hasil. Didapat 96 subjek yang memenuhi kriteria penelitian. Subjek berpotensi mengalami PIOO 41,6% dengan tingkat keparahan kontraindikasi (4,70%), berat (60,70%), dan sedang (34,60%). Jenis PIOO paling sering adalah deksametason dan flukonazol yang berpotensi meningkatkan paparan glukokortikoid. Terdapat perbedaan bermakna pada faktor usia (p=0,037), lama hari rawat (p=0,000), dan rerata jumlah obat (p=0,000), sedangkan komorbiditas tidak menunjukkan perbedaan (p=0,082). Kesimpulan. Angka kejadian PIOO pasien leukemia akut pada anak yang menjalani rawat inap di RSCM adalah 41,6%. Faktor usia, lama hari rawat, dan rerata jumlah obat berpengaruh signifikan terhadap kejadian PIOO dengan nilai OR 1,8 terhadap pasien berusia >7 tahun, 6,3 terhadap pasien dengan lama hari rawat >7 hari, dan 5,3 terhadap pasien dengan rerata pemberian >4 obat per hari. Sari Pediatri 2016;18(2):129-36Kata kunci: kemoterapi, interaksi obat, leukemia akut, micromedex, pediatrik. Figures Genesis and Factors of Potential Drug-Drug Interactions in Pediatric Inpatient with Acute LeukemiaSri Wulandah Fitriani, Rina Mutiara, Amarila Malik, Murti Andriastuti Background. Risk of potential drug-drug interactions (pDDIs) in patients with acute leukemia due to administration of multidrug therapy is quite high, and studies in pediatric patients have not been done before. Objectives. To determine the incidence and factors that affect pDDIs. Methods. A cross-sectional study design with the subjects of pediatric inpatient with acute leukemia in RSCM from January to December 2014. Data obtained through the electronic prescription retrospectively. PDDIs were identified by Micromedex Drug Reax® software. Results. Ninety six pediatric inpatient fulfilled the criteria. PDDIs were identified in 41,6% samples with the severity of contraindications (4,70%), major (60,70%), and moderate (34,60%). The most frequent pDDIs involved dexamethasone and fluconazole that potentially increased glucocorticoid exposure. There are significant differences in the factor of age (p=0.037), length of stay (LOS) (p=0.000), and the mean number of medications (p=0.000), while comorbidity showed no significant difference (p=0.082). Conclusions. Incidence rates of pDDIs in pediatric inpatient with acute leukemia in RSCM is 41.6%. Age, LOS, and the mean number of medications have significant differences on the incidence of pDDIs with OR 1.8 for the patients aged >7 years, 6.3 for the patients with LOS >7 days, and 5.3 of the patients with >4 drugs given per day. Sa...

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Parent-Reported Symptoms and Medications Used Among Children With Severe Neurological Impairment

et al. 2020

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IMPORTANCE Children with severe neurological impairment (SNI) often take multiple medications to treat problematic symptoms. However, for children who cannot self-report symptoms, no system exists to assess multiple symptoms and their association with medication use. OBJECTIVESTo assess the prevalence of 28 distinct symptoms, test whether higher global symptom scores (GSS) were associated with use of more medications, and assess the associations between specific symptoms and medications. DESIGN, SETTING, AND PARTICIPANTSThis cross-sectional study was conducted between April 1, 2019, and December 31, 2019, using structured parent-reported symptom data paired with clinical and pharmacy data, at a single-center, large, hospital-based special health care needs clinic.Participants included children aged 1 to 18 years with SNI and 5 or more prescribed medications. Data analysis was performed from April to June 2020. EXPOSURE During routine clinical visits, parent-reported symptoms were collected using the validated 28-symptom Memorial Symptom Assessment Scale (MSAS) and merged with clinical and pharmacy data. MAIN OUTCOMES AND MEASURESSymptom prevalence, counts, and GSS (scored 0-100, with 100 being the worst) were calculated, and the association of GSS with medications was examined. To evaluate associations between symptom-medication pairs, the proportion of patients with a symptom who used a medication class or specific medication was calculated. RESULTSOf 100 patients, 55.0% were boys, the median (interquartile range [IQR]) age was 9 (5-12) years, 62.0% had 3 or more complex chronic conditions, 76.0% took 10 or more medications, and none were able to complete the MSAS themselves. Parents reported a median (IQR) of 7 (4-10) concurrent active symptoms. The median (IQR) GSS was 12.1 (5.4-20.8) (range, 0.0-41.2) and the GSS was 9.8 points (95% CI, 5.5-14.1 points) higher for those with worse recent health than usual. Irritability (65.0%), insomnia (55.0%), and pain (54.0%) were the most prevalent symptoms. Each 10-point GSS increase was associated with 12% (95% CI, 4%-19%) higher medication counts, adjusted for age and complex chronic condition count. Among the 54.0% of children with reported pain, 61.0% were prescribed an analgesic. CONCLUSIONS AND RELEVANCEThese findings suggest that children with SNI reportedly experience substantial symptom burdens and that higher symptom scores are associated with increased medication use. Paired symptom-medication data may help clinicians identify targets for personalized symptom management, including underrecognized or undertreated symptoms.

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Potential Drug−Drug Interactions in Infant, Child, and Adolescent Patients in Children’s Hospitals

Cited by 95 publications

References 27 publications

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Potential Drug-Drug Interactions among Prescribed Drugs in Paediatric Outpatients Department of a Tertiary Care Teaching Hospital

Angka Kejadian dan Faktor yang Memengaruhi Potensi Interaksi Obat dengan Obat pada Pasien Leukemia Akut Anak yang Menjalani Rawat Inap

Parent-Reported Symptoms and Medications Used Among Children With Severe Neurological Impairment

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