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Evaluation of KIDs List Compliance at a Children's Hospital Within a Large Academic Medical Center
Alexandra Cooper1, Shannon Lyons1, Lisa Thames1
1UF Health Shands Children's Hospital (AG, SL, LT, TS, TH, AL, AG), Gainesville, FL.
Insights
A study evaluated institutional compliance with the Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List. Many formulary drugs lacked pediatric warnings, and numerous oral liquid medications contained potentially inappropriate excipients, indicating a need for improvement.
Area of Science:
- Pediatric Pharmacology
- Drug Safety
- Health Informatics
Background:
- The Key Potentially Inappropriate Drugs in Pediatrics (KIDs) List was published in 2020 to guide safe medication use in children.
- Ensuring institutional adherence to such guidelines is crucial for optimizing pediatric patient safety.
Purpose of the Study:
- To assess an academic medical center's compliance with the KIDs List recommendations.
- To identify specific areas requiring improvement in pediatric medication management.
Main Methods:
- Compared KIDs List medications against the institutional formulary.
- Evaluated formulary entries for pediatric-specific order comments and restrictions.
- Assessed oral liquid and common intravenous (IV) medications for potentially inappropriate excipients.
- Solicited pediatric clinical specialists for further recommendations.
Main Results:
- 70.1% of KIDs List medications were available in the formulary.
- Only 8.5% of formulary KIDs List medications had pediatric warnings.
- 76.3% of reviewed oral liquid medications contained potentially inappropriate excipients.
- 15% of reviewed IV medications contained potentially inappropriate excipients.
Conclusions:
- The institution's formulary includes many KIDs List medications, but few have integrated pediatric warnings.
- A significant proportion of oral liquid and some IV medications may pose risks due to excipients.
- Further review is needed to implement KIDs List recommendations and enhance pediatric medication safety.
Objectives:
In 2020, a list of Key Potentially Inappropriate Drugs in Pediatrics, known as the "KIDs List," was published. The objective of this analysis was to evaluate institutional compliance with the -recommendations in this publication and identify areas for improvement.
Methods:
Medications in the KIDs List were compared to the institutional formulary at a large academic medical center caring for pediatric and adult patients. Medications listed in the formulary were then -evaluated for order comments and restrictions related to their use in pediatric patients. Oral liquid products and a group of commonly used intravenous (IV) medications were reviewed for potentially inappropriate excipients through available manufacturer information. The pediatric clinical specialists were then solicited to review and make recommendations for medications that had not been addressed.
Results:
Of the 67 medications or classes listed in the KIDs List, 47 (70.1%) of the medications are listed in our formulary and available for use. Of these 47 medications, 4 (8.5%) included warnings related to their use in pediatric patients. Of the 270 oral liquid medications reviewed, 206 (76.3%) contained at least 1 -potentially inappropriate excipient. Of the 20 commonly used IV medications, 3 (15%) contained at least 1 potentially inappropriate excipient.
Conclusions:
This review found that many medications listed in the KIDs List are included in our -institution's formulary and that few have warnings for pediatric patients built into the institutional electronic health record. Further review of medications in the formulary will be conducted to determine the next steps to implementing KIDs List recommendations.
