The status of drug wastage in the pediatric emergency department of a tertiary hospital

Abstract

Background : The aim of this study was to evaluate surplus drugs left over from medications used via the intravenous and intramuscular routes in a pediatric emergency unit of a tertiary hospital in Turkey and to determine the financial burden imposed by drug wastage. Materials and Methods : The study was planned prospectively on patients presenting to the pediatric emergency department of a tertiary university hospital between January 1 and April 30, 2017, on weekdays and between 08:00 and 16:00, for any reason, and receiving intravenous and/or intramuscular drug administration resulting in drug wastage after treatment. Results : The number of patients enrolled in the clinical trial was 1620 (35.9%). Twenty-one different medications were administered via the intravenous or intramuscular (IM) routes during the study. The proportion of total medication wastage at the end of trial was estimated to be 0.425. The drug with the highest proportion of mean wastage to drug form was paracetamol (1000mg vial) at 0.79. The total cost of the drugs used for the patients in the study was US$580.98, and the overall burden of drug wastage was US$288.09. The three medications involving the highest wastage costs were methylprednisolone, ondansetron, and dexamethasone. The total wastage cost/total drug cost ratio was 0.495. Conclusion : If commercial drugs with intravenous and IM formulations are used by the pediatric age group, then dosage formulations appropriate for pediatric age group use also need to be produced. The development by manufacturers of ampoules and similar products suitable for multiple use will also reduce drug wastage. Reducing levels of drug wastage will inevitably reduce the drug expenditure.

A General Evaluation of the Reasons for Medication Wastage: A University Hospital Example

“…In the same study, it was seen that the departments with the highest medication waste cost were pharmacy and inpatient services. In a study conducted over four months in the pediatric emergency department of a university hospital in Turkey, the cost of medication wastage was $288.09 (Bucak et al, 2020). In order to reduce the amount and the cost of medication wastage and use resources effectively and efficiently, it is important to study preventable causes of medication wastage in the departments where the most wastage occurs.…”

“…It has been determined that various causative factors are associated with wastage including physician's order, distribution of drugs from pharmacies to units, failure to respond to treatment, treatment changes, allergies, expiration of the drug, and adverse drug reactions (Braund et al, 2009a;Braund et al, 2009b;Dobson & Tilson, 2016). It has been stated that medication wastage occurs in various units of hospitals, especially in emergency services, operating rooms, intensive care, oncology and hematology units, and intensive and specialized units where pediatric patients are admitted (Ang et al, 2020;Bach et al, 2016;Bucak et al, 2020;Fasola et al, 2014;Peker, 2020;Şerefoglu, 2021).…”

Reductions in Medication Wastage and Costs in a Pediatric Intensive Care Unit by Changing the Order Entry System

“…The production of multipledose formulations by pharmaceutical companies will also be helpful in this regard. Finally, reducing drug wastage will automatically decrease drug costs [9].…”

Intravenous paracetamol: Salvage and safety proposition

“…Recent data on drug wastage in the paediatric emergency department found that paracetamol (100 ml vial) was the drug with the highest proportion of mean wastage. [ 6 ] Smaller vials would be more economical.…”