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Prevalence of Clinically Significant Drug-Drug Interactions Across US Children's Hospitals

James W Antoon1,2, Matt Hall3, Alison Herndon4,2

  • 1Monroe Carell Jr. Children's Hospital at Vanderbilt, Nashville, Tennessee; james.antoon@vumc.org.

Pediatrics
|October 10, 2020
PubMed

Insights

Pediatric patients in US children's hospitals often receive medications with significant drug-drug interactions (DDIs). Prescribing rates for these DDIs varied widely across hospitals, indicating a need for safer medication practices.

Area of Science:

  • Pediatric Pharmacology
  • Hospital Pharmacy
  • Drug Safety

Background:

  • Limited data exists on medication prescribing with potential drug-drug interactions (DDIs) in pediatric populations.
  • Understanding DDI prevalence in children's hospitals is crucial for patient safety.

Purpose of the Study:

  • To determine the prevalence and variation of prescribing medications with clinically significant DDIs in US children's hospitals.
  • To identify patient-level risk factors associated with DDI exposure.

Main Methods:

  • Retrospective cohort study of patients under 26 years old discharged from 52 US children's hospitals (2016-2018).
  • Evaluation of 53 drug pairings with clinically significant DDIs in children.
  • Multivariable logistic regression and generalized linear mixed-effects models used to analyze DDI exposure.

Main Results:

  • 2.0% of hospitalizations (47,414) involved DDI pairings, with 25% being contraindicated.
  • Significant variation in DDI prescribing rates across hospitals (1.05% to 4.92%).
  • Factors like older age, complex chronic conditions, longer stay, and surgical encounters increased DDI risk.

Conclusions:

  • US children's hospitals frequently expose patients to medications with significant DDIs.
  • Substantial hospital-level variation in DDI exposure necessitates further investigation.
  • Research is needed to assess adverse events and develop interventions for safer medication use.
Abstract

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