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Epidemiology of medication-related problems in children with kidney disease

Norkasihan Ibrahim1, Ian Chi Kei Wong, Stephen Tomlin

  • 1Centre for Paediatric Pharmacy Research, School of Pharmacy, University College London, London, UK.

Pediatric Nephrology (Berlin, Germany)
|October 30, 2014
PubMed

Insights

Medication-related problems (MRPs) affect over half of hospitalised children with kidney conditions. Sub-optimal drug effects were common, highlighting the need for better preventive strategies in paediatric pharmacotherapy.

Area of Science:

  • Pharmacology
  • Paediatric Nephrology
  • Patient Safety

Background:

  • Medication-related problems (MRPs) are adverse effects of pharmacotherapy with potential for harm.
  • The epidemiology of MRPs in paediatric renal patients remains largely uncharacterised.
  • This study aimed to characterise MRPs in children with renal conditions at UK tertiary care hospitals.

Purpose of the Study:

  • To determine the incidence and characteristics of medication-related problems (MRPs) in paediatric renal patients.
  • To identify predictors and assess the severity of MRPs in this population.
  • To inform strategies for optimising pharmacotherapy in children with kidney diseases.

Main Methods:

  • Retrospective review of prescription charts for paediatric patients (≤18 years) at two UK tertiary care hospitals.
  • Identification and characterisation of MRPs using a standardised proforma and operational definition.
  • Logistic regression analysis to evaluate MRP predictors and a validated scale for severity assessment.

Main Results:

  • 267 MRPs were identified from 266 prescription chart reviews.
  • Incidence of MRPs was 51.2% in inpatients and 32% in outpatients.
  • Sub-optimal drug effect was the predominant MRP type; prescribing errors and medicine-taking behaviour were key contributors. Severity was minor or moderate.

Conclusions:

  • Multiple, cumulative, and interdependent factors are associated with MRPs in paediatric renal patients.
  • Investment in preventive strategies is crucial for optimising pharmacotherapy.
  • Extending healthcare support from acute settings into the community can improve medication safety.
Abstract

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