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Epidemiology and potential risk factors of drug-related problems in Hong Kong paediatric wards
Insights
Drug-related problems (DRPs) are common in hospitalized children in Hong Kong, with dosing and drug choice issues being most frequent. Most DRPs were preventable, indicating a need for improved medication safety in pediatric care.
Area of Science:
- Pediatric Pharmacology
- Clinical Pharmacy
- Patient Safety
Background:
- Drug-related problems (DRPs) significantly impact patient outcomes.
- The prevalence and characteristics of DRPs in hospitalized children in Hong Kong are not well-documented.
- Understanding DRPs is crucial for improving pediatric healthcare.
Purpose of the Study:
- To determine the epidemiology of DRPs in hospitalized children in Hong Kong.
- To identify risk factors associated with DRPs in this population.
- To inform strategies for reducing DRPs in pediatric patients.
Main Methods:
- Prospective cohort study involving children aged 0–18 years across seven Hong Kong hospitals.
- Daily review of patient charts, medical records, and laboratory data to identify DRPs.
- Logistic regression analysis to identify risk factors for DRP incidence.
Main Results:
- The overall incidence of DRPs was 21.0% among 329 hospitalized children.
- Dosing problems (42.7%) and drug choice problems (23.2%) were the most common DRPs.
- Most DRPs (81.7%) were preventable, with 51.2% classified as minor and 48.8% as moderate.
Conclusions:
- Drug-related problems are prevalent in hospitalized children in Hong Kong.
- Dosing and drug choice issues are the most frequent DRPs, and most are preventable.
- Polypharmacy and certain infectious diseases are potential risk factors for DRPs.
Aims:
A drug-related problem (DRP) is ‘an event or circumstance involving drug therapy that actually or potentially interferes with the desired health outcome’. The extent and characteristics of DRPs in children in Hong Kong are unknown. The aim of this study was to determine the epidemiology of and identify riskf actors for DRPs in hospitalized children in Hong Kong.
Methods:
This was a prospective cohort study in children aged 0–18 years who were admitted to a medical ward, paediatric intensive care unit or neonatal intensive care unit of seven Hong Kong hospitals, during a 3 month period. Patients’ charts, medical records and laboratory data were reviewed daily to identify DRPs; their preventability and severity were assessed. Logistic regression was used to analyse potential risk factors associated with the incidence of DRPs.
Results:
Three hundred and twenty-nine children (median age, 2 years; interquartile range, 0 months to 9 years) were included. In total, 82 DRPs were experienced by 69 patients. The overall incidence of DRPs was 21.0% (95% confidence interval, 16.7–25.8%). The incidence was higher in neonatal and paediatric intensive care units than medical wards. Dosing problems were the most frequently reported DRPs (n = 35; 42.7%), followed by drug choice problems (n = 19; 23.2%) and adverse drug reactions (n = 11; 13.4%). Sixty-seven (81.7%) DRP cases were assessed as preventable, 42 (51.2%) as minor and 40 (48.8%) as moderate. The number of prescribed drugs and ‘certain infectious and parasitic diseases’ were potential risk factors for occurrence of DRPs.
Conclusions:
Drug-related problems were common in hospitalized children in this study in Hong Kong; the most frequent were dosing and drug choice problems, and the majority of them were preventable. Polypharmacy and ‘certain infectious and parasitic diseases’ were potential risk factors.
