Drug-related problems in hospitalised children in the United Kingdom and Saudi Arabia

Abstract

BACKGROUND: Drug-related problem (DRP) is ‘‘an event or circumstance involving drug therapy that actually or potentially interferes with the desired health outcome’’.[1] The extent and characteristics of DRPs in children in the UK and Saudi Arabia (KSA) is unknown. AIM: Our aim was to identify the incidence and characteristics of DRPs in children attending A&E/admitted to a hospital in the two countries. METHODS: A prospective cohort study in children aged 0–18 years admitted to the medical ward, paediatric intensive care unit (PICU), and neonatal intensive care unit (NICU) or attending A&E during a three month period in two hospitals were carried out. Data were collected on a form adapted from the Pharmaceutical Care Network in Europe (PCNE) DRP-Registration Form V5.01. Patients’ charts, medical records and laboratory data were reviewed daily to identify DRPs; their preventability and severity were assessed. RESULTS: 990 children [median 3 years, IQR; 10 months – 8 years, 58.6% male] were included. 388 patients suffered from 546 DRPs. Overall DRP incidence was 39.2% (95% CI, 36.1, 42.3) being higher in KSA than in the UK (44.8% vs 33.3%, p< 0.001). Incidence was found to be highest in PICU (59.7%; 95% CI, 47.0, 71.5). Dosing problems were the most frequently reported DRPs (n= 303, 55.5%), followed by drug choice problems (n = 91, 16.7%). 80.0% of DRP cases were preventable; 71.4% (n = 390) DRPs were assessed as minor and 27.8%(n = 152) as moderate. 295 (54.0%) were totally resolved, of which 220 (74.6%) were resolved by pharmacists. CONCLUSIONS: DRPs are a significant problem in the paediatric population in the UK and KSA, the majority of which are preventable. Increased focus on paediatric pharmacology and pharmacotherapy within paediatric medical and nursing education is an important step in improving prescribing practices.