Prescribing for children at the interfaces of care

Area of Science:

• Pediatric pharmacology
• Healthcare policy
• Clinical pharmacy

Background:

• Pediatric prescribing differs significantly from adult prescribing due to unique physiological needs and medication requirements.
• The transition of care between primary, secondary, and tertiary settings poses challenges for medication management in children.
• Unlicensed medicines, often termed 'specials,' are frequently required for pediatric patients, leading to procurement and prescribing complexities.

Purpose of the Study:

• To review current prescribing arrangements for children at care interfaces in England.
• To identify challenges in medication continuity, shared care, and access to unlicensed medicines for pediatric patients.
• To highlight potential service improvements for maintaining medication access for children.

Main Methods:

• Review of current policies and practices in England concerning pediatric prescribing at care interfaces.
• Analysis of prescribing responsibility, shared-care models, and medication continuity protocols.
• Examination of issues related to unlicensed medicines and continuing care medication arrangements.

Main Results:

• Prescribing for children at care interfaces is complex, involving issues of responsibility and access to unlicensed medicines.
• Shared-care arrangements and medication continuity during hospital admission/discharge require careful management.
• Procurement of unlicensed medicines (specials) from community pharmacists can be problematic.

Conclusions:

• Current systems for pediatric prescribing at care interfaces in England require optimization.
• Service changes are needed to ensure consistent and safe access to necessary medications for children.
• Addressing challenges in unlicensed medicine provision and care coordination is crucial for pediatric patient safety.