The responsibility of clinical pharmacists for the safety of medication use in hospitalized children: A Middle Eastern experience

Abstract

Objective: We aimed to detect and report the frequency of occurrence of drug-related problems (DRPs) in a Middle Eastern University Children's Hospital (Isfahan, Iran) and classify them in terms of their nature and cause to clarify the responsibility of clinical pharmacists for the safe utilization of medications in hospitalized children. Methods: In this cross-sectional study which was carried out in Imam Hossein Children's University Hospital affiliated with Isfahan University of Medical Sciences (Isfahan, Iran) from September 2017 to May 2018, DRPs during the hospitalization of pediatric patients in three medical wards, the pediatric intensive care unit, and two neonatal intensive care units were detected and identified concurrently with the treatment process using Pharmaceutical Care Network of Europe data gathering form for DRPs v. 8.01. All cases were verified and validated in a professional focus group before documentation. Findings: We detected 427 DRPs in 201 out of 250 randomly included hospitalized children in which 86% of them were directly reported by the hospital's clinical pharmacist. The highest frequency of DRPs (47.3%) was observed in the age range of 1 month–2 years. Safety of treatment was the most frequently reported as the nature of the problem (43.5%), followed by effectiveness issues (36.8%). The most frequent cause of DRPs was dose selection issues (34.2%), followed by drug-type selection (25.5%), and unavailability of appropriate dosage forms (13.6%). Ninety-eight interventions were proposed by the clinical pharmacist, in which 59.2% of them were accepted. Conclusion: This study confirms the necessity for the active role of clinical pharmacists before, during, and after drug therapy in hospitalized pediatric patients for the safety and proper utilization of drugs in this vulnerable population.

Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

“…Of patients with at least one DRP, 65.7% had an average of 0.92 ± 0.8 DRP per prescription; this was higher than results in previous studies, which reported 35.6% and 31.6% [ 3 , 5 ]. However, our proportion was lower than that of Jafarian et al, who reported that 80.1% of patients had at least one DRP [ 2 ]. Such disparities may be due to study population, differences in prescribed drugs, classifications, and reference resources used to determine DRPs.…”

“…Patients younger than 6 years old accounted for about 80% of participants, and their mean age was 4.3 ± 3.6. The physiological characteristics and body development in these age groups closely resembled those found between male and female patients, indicating that sex did not affect the risk of DRP occurrences in children [ 2 ]. Among the ICD-10 groups, the highest proportion had respiratory diseases.…”

“…DRPs can occur in various patient populations and ages. In particular, the appearance of DRPs in pediatric patients has become a major concern, with about 30 to 40% of pediatric patients experiencing at least one DRP [ 2 ]. Most DRPs are related to prescribing: drug selection, dosage, and usage [ 3 , 4 ].…”

“…However, because of the complexity of pediatric cases’ treatment, the DRPs rate in some developing countries was surprisingly high, reported from 31.57% to 80.1% [ 2 , 3 , 5 ]. Despite the fact that DRPs in outpatients are very common and contribute to iatrogenic morbidity [ 7 ], studies have accessed DRPs in the inpatient pediatric setting [ 2 , 8 , 9 ], and little is known about this outpatient rate [ 10 ], particularly in Vietnam. Additionally, the impacts of DRPs occurring in outpatients and inpatients are the same in terms of treatment efficacy, safety, and cost.…”

A Study of Current Medication of Sinupret Drops in Chinese Pediatric Patients

“…However, Sinupret drops has still been misused as ear drops or nose drops in our collected cases. Wrong drug delivery is largely responsible for the medication error [21]. As a result, it is strongly recommended to increase warning signs and to strengthen medication education for drug dispensers of pediatric patients.…”