Reducing Stimulant Prescribing Error: A Quality Improvement Initiative in Pediatric Outpatient Setting

Area of Science:

• Pediatric Healthcare
• Clinical Pharmacy
• Quality Improvement

Background:

• Attention Deficit Hyperactivity Disorder (ADHD) management requires careful attention to stimulant prescribing.
• Medication errors in pediatric ADHD care can impact patient safety and treatment efficacy.
• Multidisciplinary approaches are crucial for optimizing ADHD treatment protocols.

Purpose of the Study:

• To evaluate the impact of the Songklanagarind ADHD Multidisciplinary Assessment and Care Team for Quality Improvement (SAMATI) initiative.
• To assess the reduction in stimulant prescribing errors within a pediatric outpatient setting.
• To measure changes in parental satisfaction following the SAMATI initiative implementation.

Main Methods:

• Retrospective analysis of ADHD registry data from January 2017 to June 2023.
• Interrupted time series and control chart analyses to evaluate the SAMATI initiative's effect.
• Inclusion of audit and feedback, clinical pharmacist involvement, and Electronic Medical Record utilization.

Main Results:

• Significant reductions in prescribing errors, including drug-condition interactions (443 to 145) and inadequate monitoring (115 to 14).
• Decreases in lack of regular office visits (98 to 21) and inappropriate dosage errors (66 to 14).
• Improved parental satisfaction from 84% to 95% post-initiative.

Conclusions:

• The SAMATI initiative effectively reduced stimulant prescribing errors in pediatric ADHD care.
• The multidisciplinary approach demonstrated significant improvements in medication management and patient safety.
• Enhanced parental satisfaction indicates a positive impact on the overall quality of ADHD care.