Risk factors for adverse drug reactions in pediatric inpatients: a systematic review

Andrade, Paulo Henrique Santos; Santos, Adriano da Silva; Souza, Carlos Adriano Santos; Lobo, Iza Maria Fraga; Silva, Wellington Barros da

doi:10.1177/2042098617702615

Cited by 22 publications

(25 citation statements)

References 23 publications

(142 reference statements)

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“…The occurrence of ADEs is associated with both patient characteristics and their health care utilization. With regard to risk factors associated with ADEs in pediatric patients, significant differences have been found in terms of the number of drugs 14 , length of hospital stay 15 , use of antibacterial 15 and general anesthesia 16 . However, such findings are not always consistent; while some studies found that gender was not significantly associated with ADEs 17 , a study also found that males were at higher ADEs risk compared to females 18 .…”

Section: Introductionmentioning

confidence: 99%

Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool

Song

Xiao

et al. 2018

Sci Rep

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Understanding the epidemiology and risk factors of adverse drug events (ADEs) in pediatric inpatient is essential if we are to prevent, reduce or ameliorate the harm experienced. The Global Trigger Tool (GTT) is a method of retrospective medical record review that measures harm in hospitalized children. We employed a three-stage retrospective chart review of random samples of 1800 pediatric inpatients discharged from January 2013 to December 2015. 31 kinds of pediatric-specific triggers were made based on the previous trigger tool studies developed for use in adult or pediatric. Positive predictive value (PPV) of individual triggers, as well as ADEs detection rates were calculated. Stepwise logistic regression was performed to investigate risk factors associated with ADEs. Of 1746 patients, detected in 221 patients (12.7%) with 247 ADEs. The PPV of the trigger tool was 13.3%. Of the 247 ADEs, 82.6% were identified as category E, 11.7% category F and 5.7% category H. The pediatric-focused trigger tool is a feasible and useful tool for detecting pediatric ADEs. Especially for patients who have had more drugs, more doses or more admissions which needs to be closely monitored as triggers to improve the safety.

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Section: Introductionmentioning

confidence: 99%

Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool

Song

Xiao

et al. 2018

Sci Rep

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“…The main risk factor for adverse drug reaction occurrence in the pediatric population is the increase in the number of prescription drugs (11). In this study, the number of patients prescribed two or more drugs were 510 among 1500 prescriptions; 253 of these (49.6%) included 2 drugs, 228 (44.7%) included 3-4 drugs, and 29 (5.6%) included ≥5 drugs.…”

Section: Discussionmentioning

confidence: 77%

Pediatri kliniğinde potansiyel ilaç-ilaç etkileşimlerinin değerlendirilmesi

Terzioğlu Bebitoğlu

2019

Turk Pediatri Ars

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Aim: A large number of medications are prescribed in pediatric clinics and this leads to the development of drug-drug interactions (DDI) that may complicate the course of the disease. The aim of the study was to identify the prevalence of potential drug-drug interactions, to categorize main drug classes involved in severe drug-drug interactions and to highlight clinically relevant DDIs in a pediatric population. Material and Methods: A total of 1500 prescriptions during the 12-month study period were retrospectively reviewed; 510 prescriptions that comprised two or more drugs were included in study. The presence of potential drug-drug interactions was identified by using the Lexi-Interact database and categorized according to severity: A (unknown), B (minor), C (moderate), D (major), and X (contraindicated). Results: There were 1498 drugs in 510 prescriptions; 253 of these (49.6%) included 2 drugs, 228 (44.7%) included 3-4 drugs, and 29 (5.6%) included ≥5 drugs. A total of 634 (42%) potential drug-drug interactions were idenfied. Among those, 271 (42.7%) were catego-Öz Amaç: Çocuk kliniklerinde çok sayıda ilaç reçete edilmektedir ve bu durum hastalığın seyrini kötüleştirebilecek ilaç-ilaç etkileşimlerinin oluşmasına neden olabilmektedir. Bu çalışmanın amacı, potansiyel ilaç-ilaç etkileşimlerinin yaygınlığını ve ciddi etkileşime giren başlıca ilaç gruplarını belirlemek ve çocuk yaş grubunda klinik olarak önemli ilaç-ilaç etkileşimlerini vurgulamaktır. Gereç ve Yöntemler: 12 aylık çalışma döneminde toplam 1 500 reçete geriye dönük olarak incelendi; bunlar içerisinden iki ya da daha fazla ilaç içeren 510 reçete çalışmaya alındı. Potansiyel ilaç-ilaç etkileşimlerinin varlığı, Lexi-Interact veritabanı kullanılarak belirlendi ve ciddiyetine göre sınıflandı: A (bilinmeyen), B (minor), C (orta), D (major) ve X (kontrendike). Bulgular: 510 reçetede toplam 1498 ilaç vardı; bunların 253'ü (%49,6) 2 ilaç, 228'i (%44,7) 3-4 ilaç ve 29'u (%5,6) ≥5 ilaç içermekte idi. Toplam 634 (%42) potansiyel ilaç-ilaç etkileşimi belirlendi. Bunlardan 271'i (%42,7) A, 284'ü (%44,8) B, 53'ü (%8,4) C ve 26'sı (%4,1) D grubu The known about this topic Considering the principles of rational drug use which considers the efficacy, safety, suitability and the cost of medication during treatment regimens would also prevent the occurrence of many drug-drug interactions. This is especially important for pediatric population, where the pharmacokinetic parameters of the medications are very different from adult population. There is scarce data on drug-drug interactions and pharmacokinetics profiles in pediatric population due to ethical and practical limitations. Contribution of the study The results of this study give detailed information about the abundance of potential clinically significant drug-drug interactions and their mechanisms in a Pediatric clinic. The studies performed on adult population extrapolated to the pediatric population may result in under or over prediction of the severity of drug-drug interactions. Therefore the prevalence of pot...

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“…Concepts and terms established by the WHO9 were the reference base for the development of DOMAIN 1 . Several authors discussed the risk factors for the development of ADRs in Paediatrics, among them the exposure to multiple drugs, lack of defined doses for this age group, inadequate frequency, drug administration, period of permanence at the hospital, liver and kidney disease or immaturity and use of off label drugs 6 16–19. Studies show that the drug groups that promote ADRs in Paediatrics most are antibiotics and vaccines, mainly as dermatological reactions 20–23…”

Section: Methodsmentioning

confidence: 99%

Development and validation of a questionnaire for the assessment of the knowledge, management and reporting ADR in paediatrics by healthcare teams (QUESA-P)

et al. 2019

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ObjectiveWe aimed to develop and validate a new instrument called Questionnaire for the assessment of the knowledge, management and reporting ADR in Paediatrics by Healthcare teams (QUESA-P).DesignThis is a cross-sectional study.Settings and participantsTeams of healthcare professionals (HCP) that lead with pharmacological therapy in Paediatrician’s sector (Paediatric-HCP) in seven public hospitals in Brazil.OutcomeAn assessment of the knowledge and current management of ADR in Paediatric-HCP.MethodsWe developed and validated QUESA-P, using a standardised procedure which included item development and psychometric prevalidation using Cronbach’s Alpha, item-total correlation and test–retest validity for internal consistency and reliability. External criterion was used as criterion validation (the instrument was applied to the focus group expert vs focus group team of Paediatric-HCP in hospitals). The focus group of experts who participated in psychometrics was asked to respond to the QUESA-P twice in order to assess test-retest reliability. The content validity of the initial questionnaire was assessed by the Delphi method and pilot test. Subsequently, we made minor revisions and finalized the QUESA-PResultsSelection of domains and facets were based on literature review made in duplicate by authors. Content validity was done by trial of different examiners (panellists, n=16), conducting analysis through Delphi method (three rounds). The QUESA-P was constructed with three domains. The intraclass correlations (0.80) and the Cronbach’s alpha coefficient (0.82), indicated adequate test–retest reliability and internal consistency for each domain. The application of the QUESA to 61 Paediatric-HCP in hospital resulted in lower mean score of 42.1 ± 3.4 in all domains when compared with expert teams (n= 46) 48.2 ± 3.7 (p <0.001) indicating that the instrument is valid to discriminate QUESA experts and Paediatric-HCP.ConclusionThe selected domains can be used to check weaknesses in the identification, management and reporting of suspected ADR by Paediatric-HCP in Brazil.

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Risk factors for adverse drug reactions in pediatric inpatients: a systematic review

Cited by 22 publications

References 23 publications

Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool

Adverse drug events in Chinese pediatric inpatients and associated risk factors: a retrospective review using the Global Trigger Tool

Pediatri kliniğinde potansiyel ilaç-ilaç etkileşimlerinin değerlendirilmesi

Development and validation of a questionnaire for the assessment of the knowledge, management and reporting ADR in paediatrics by healthcare teams (QUESA-P)

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