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Can de facto dosing practices bridge the knowledge gap in pediatric medication recommendations?
Elisabeth L Scheufele1, Anil Dubey
1Massachusetts General Hospital, Boston, MA, USA.
AMIA ... Annual Symposium Proceedings. AMIA Symposium
|March 31, 2010
Summary
Pediatric levothyroxine dosing often deviates from recommendations, with most prescriptions being too low. Analyzing real-world electronic prescribing data can inform clinical decision support systems for children.
Area of Science:
- Pediatric Endocrinology
- Clinical Pharmacology
- Health Informatics
Background:
- A significant knowledge gap exists in pediatric medication dosing.
- Researching medication efficacy and safety in children presents unique challenges.
- Electronic prescribing data offers a potential resource for understanding real-world dosing practices.
Purpose of the Study:
- To investigate de facto pediatric weight-based levothyroxine dosing practices.
- To assess the utility of electronic prescribing data for clinical decision support.
- To compare actual prescribing practices with established pediatric medication recommendations.
Main Methods:
- Extracted physical exam and prescription data from a clinical data warehouse.
- Calculated weight-based levothyroxine dosing from electronic prescriptions.
- Compared calculated doses against established pediatric dosing guidelines.
Main Results:
- Analyzed 854 pediatric levothyroxine prescriptions.
- 85.2% of prescriptions were below the recommended weight-based dosage range.
- 9.37% were within the recommended range, and 5.39% were above.
Conclusions:
- Real-world pediatric levothyroxine prescribing practices frequently differ from established recommendations.
- Electronic prescribing data analysis can identify these discrepancies.
- This information is valuable for developing pediatric clinical decision support tools, especially where dosing data is sparse.
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