High-risk pediatric medications: A listing proposal by interdisciplinary consensus technique

Area of Science:

• Pediatric Pharmacology
• Medication Safety
• Hospital Pharmacy Practice

Background:

• Pediatric patients face higher risks of medication errors and harm.
• Identifying high-risk medications (HRM) is crucial for safety improvement strategies.
• Special populations, like children with excess body weight, require focused attention.

Purpose of the Study:

• To create an updated, operational list of HRM for hospital use in children over two years of age.
• To achieve consensus through an interdisciplinary group of pediatricians and hospital pharmacists.
• To support collaborative efforts between the Spanish Society of Hospital Pharmacists and the Spanish Society of Pediatric Hospital Medicine.

Main Methods:

• A two-phase approach was used: bibliographic review for a preliminary list and a double-round Delphi method for consensus.
• The study involved 37 experts, with 32 (86.4%) completing both Delphi rounds.
• Results were validated using chance agreement probability and modified Kappa statistics.

Main Results:

• The initial review identified 26 pharmacological classes and 96 drugs.
• The final consensus list includes 24 pharmacological classes and 100 HRM.
• A high level of agreement (94.9% via modified Kappa statistic) was achieved among participants.

Conclusions:

• The developed list serves as a valuable tool for future research and interventions.
• It aims to enhance medication safety in the general pediatric population.
• The list is particularly relevant for high-risk pediatric subgroups, including those with excess body weight.