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Rational prescribing and dispensing of oral dosage forms of medicines to children: an observational study
Leila Kenzu Kemal1, Rahel Belete Abebe2, Ashenafi Kibret Sendekie2
1Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia kenzuleyla@gmail.com.
Insights
Rational prescribing of oral medications for children is a challenge. Many prescribed pediatric oral dosage forms were not suitable for weight or age, and required manipulation, indicating poor prescribing and dispensing practices.
Area of Science:
- Pediatric Pharmacology
- Public Health
- Pharmaceutical Sciences
Background:
- Irrational prescribing and dispensing of oral medications for children is a significant global public health concern, particularly in resource-limited settings.
- Key challenges include the lack of age-appropriate dosage forms and insufficient dose flexibility in available medications for pediatric patients.
Purpose of the Study:
- To evaluate the rationality of prescribing and dispensing practices for oral dosage forms administered to children at the University of Gondar Comprehensive and Specialized Hospital (UoGCSH).
Main Methods:
- A mixed-methods approach combining retrospective analysis of prescribing indicators (n=931) and a cross-sectional study of dispensing indicators (n=400) was employed.
- Data were collected from outpatient dispensary units at UoGCSH and analyzed using SPSS V.26.0.
- Descriptive statistics and chi-squared tests were used to analyze and compare prescribing and dispensing indicators.
Main Results:
- Only 16.13% of oral dosage forms were appropriate for the child's weight, with many prescriptions lacking weight information.
- A notable 7.1% of oral dosage forms were unsuitable for the child's age.
- Nearly 40% of dispensed medications required manipulation before administration, and only 0.8% were adequately labeled.
Conclusions:
- Prescribing and dispensing practices for pediatric oral medications at UoGCSH demonstrated significant shortcomings.
- A low proportion of medications were weight-appropriate, and a considerable number were not age-suitable or required manipulation.
- Improvements in medication formulation and dispensing procedures are crucial to ensure rational use in pediatric populations.
Introduction:
Irrational prescribing and dispensing of oral dosage forms of medicines to paediatric patients are major public health issues, especially in low-income and middle-income countries. Many challenges affect the rational use of oral dosage forms of medicines in children; these include a lack of dosage forms appropriate for the age and a lack of dose flexibility in dosage forms.
Objectives:
To assess the rational prescribing and dispensing practices of oral dosage forms to children at dispensaries of the University of Gondar Comprehensive and Specialised Hospital (UoGCSH).
Method:
A retrospective design for prescribing indicators and a cross-sectional study design to assess rational dispensing were used at the outpatient dispensary units of UoGCSH. A total of 931 oral dosage forms to assess prescribing indicators and 400 for dispensing indicators were used. The data were analysed using the Statistical Package for Social Sciences (SPSS V.26.0, IBM Corporation). Descriptive statistics were used to analyse indicators, and the χ2 test was used to compare indicators between dispensaries.
Result:
Out of a total of 931 oral dosage forms for 700 prescriptions, 56.3% were solid oral dosage forms. An average number of oral dosage forms per child was 1.33±0.62. Only 150 (16.13%) (95% CI: 14% to 18.4%) were adequate for the weight of the child. The percentage of oral dosage forms not suitable for the age was 7.1% (66), (95% CI: 5.6% to 8.8%), and about 0.8% (95% CI: 0% to 1.8%) were adequately labelled. Drugs that needed manipulation before administering a single unit were 81 (39.7%), 95% CI: 33.7% to 47.1%.
Conclusion:
The proportion of the prescribed medications that were adequate for the weight of the child was low, although the majority of prescriptions' weights were not recorded. Oral dosage forms not suitable for children were prescribed. The proportion of medications that needed manipulation before being administered as a single unit was high.
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