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Expert Consensus on a List of Inappropriate Prescribing after Prescription Review in Pediatric Units in Abidjan, Côte

Elisée Doffou1,2, Christelle Avi3, Kouassi Christian Yao3

  • 1Therapeutic and Clinical Pharmacy Laboratory, Faculty of Pharmaceutical and Biological Sciences, Félix Houphouët-Boigny University, Abidjan, Côte d'Ivoire.

Integrated Pharmacy Research & Practice
|September 3, 2021
PubMed

Insights

This study developed a validated list of 52 inappropriate prescribing (IP) events, including inappropriate prescriptions and omissions, to improve pediatric healthcare quality. The findings aim to optimize drug-related problem (DRP) detection and prescribing practices in pediatric units.

Area of Science:

  • Pharmacovigilance and Drug Safety
  • Pediatric Pharmacology
  • Health Services Research

Background:

  • Inappropriate prescribing (IP), encompassing both incorrect prescriptions and prescription omissions, poses a significant risk to healthcare quality in pediatric settings.
  • Identifying and addressing drug-related problems (DRPs) through a standardized list of IPs is crucial for optimizing medication management in children.
  • This study addresses the need for expert-validated criteria to assess and improve prescription practices in pediatric units.

Purpose of the Study:

  • To develop and validate a comprehensive list of inappropriate prescribing (IP) events specific to pediatric care.
  • To establish expert consensus on criteria for identifying IP, considering common drug-related problems (DRPs).
  • To provide a tool for optimizing prescription quality in pediatric units in Abidjan.

Main Methods:

  • A list of potential IPs was generated from a retrospective review of 4,992 prescription lines for 881 pediatric patients (1 month to 15 years).
  • A two-round Delphi method involving 22 pediatricians and 1 clinical pharmacist was employed for expert consensus.
  • Experts rated agreement on a 0-5 Likert scale, with >70% agreement required in round 1 and 80% in round 2 for IP retention.

Main Results:

  • The initial review identified 267 DRPs, leading to a qualitative list of 54 IPs.
  • Expert consensus, achieved through the Delphi method, resulted in a final validated list of 52 IPs (44 inappropriate prescriptions, 8 omissions).
  • High levels of expert agreement were observed, with mean ratings of 4.43/5 in round 1 and 4.6/5 in round 2.

Conclusions:

  • A validated list of 52 inappropriate prescribing events has been established for pediatric units.
  • This list serves as a valuable tool for detecting DRPs and enhancing prescription quality in pediatric care.
  • The findings are expected to contribute to improved patient safety and healthcare outcomes in pediatric units in Côte d'Ivoire.
Abstract

Keywords:
Côte d’Ivoireconsensusexpertsinappropriate prescribingpediatrics

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