Replacing Liquid Antibiotics With Cheaper Pill Equivalents: An Opportunity for Substantial Savings

ObjectiveThis study aimed to assess the number of prescriptions that were uncollected by caregivers to identify any predisposing systemic themes that may act as barriers to children receiving medications.Study design and settingData were retrospectively collected on uncollected prescriptions at a single, tertiary paediatric centre over a 2-month period. This included type and classification of the drug, prescriber specialty, the timing of prescription and the child’s registered postcode. Key themes were identified.ResultsA total of 124 uncollected prescriptions involving 94 patients were included. 103 (83%) of these were clinic prescriptions, and azathioprine was the most frequently uncollected prescription (n=6, 5%). The uncollected prescriptions most commonly fell under the ‘gastrointestinal system’ (n=26, 21%) and ‘skin’ (n=24, 19%) categories, and similarly, 24 (19%) were prescribed by the gastroenterology department and 18 (15%) by dermatology. The mean distance from the child’s registered postcode was 8.5±11.8 miles (range 0.5–73.4) with a considerable number of children having a registered postcode greater than 10 miles from the hospital (n=24, 27%). Many children lived in areas corresponding to the lowest decile of the Index of Multiple Deprivation (IMD) (n=38, 42%).ConclusionUrgent interventions and further prospective studies are needed to minimise the barriers that caregivers face in collecting their child’s prescription.

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Hard to Swallow: A Review of Interventions to Improve Swallowing Solid Medication

VandenBerg¹,

Adams²,

Bockrath³

et al. 2023

Hospital Pediatrics

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Solid oral medications are preferred over intravenous or liquid formulations; however, difficulty swallowing solid medication remains a common barrier to adherence. Previous reviews have demonstrated limited evidence on interventions to improve solid medication swallowing abilities. PubMed, Medline (OVID), CINAHL, Scopus, and Web of Science databases were searched for interventions to improve the pediatric population’s ability to swallow solid medications. We included studies in English published after the latest review, from January 2014 through April 2022, with pediatric patients not having comorbid conditions affecting swallowing ability. The authors independently reviewed each study’s sampling strategy, study design, and the strength of outcome measures and assigned a numerical rating representing “poor,” “fair,” or “good” for each category. Individual ratings were averaged per category and a final quality rating score given based on the average of all 3 categories. Our search identified 581 unique records; 10 were included in the final review. Interventions varied and included behavioral therapies and novel products or medication formulations. Three received a “good” quality rating, 5 were “fair,” and 2 were “poor.” All studies showed their intervention(s) to be successful in improving a child’s ability to swallow solid oral medications. Despite the availability of several different effective interventions, pediatric providers do not routinely address patients’ difficulty with swallowing solid oral medications. Patients would benefit from implementation of a universal screening process followed by a guideline for appropriate patient-centered interventions; the opportunity exists to use this process as a national quality benchmark reflecting institutional commitment to high-value care.

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Replacing Liquid Antibiotics With Cheaper Pill Equivalents: An Opportunity for Substantial Savings

Cited by 3 publications

References 5 publications

Switching from liquid to pill formulation saves costs

Switching from liquid to pill formulation saves costs

Themes associated with uncollected paediatric prescriptions at a large tertiary children’s hospital: a retrospective, observational study

Hard to Swallow: A Review of Interventions to Improve Swallowing Solid Medication

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