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Updated: Jan 18, 2026
Drug Repurposing Hypothesis Generation Using the "RE:fine Drugs" System
Published on: December 11, 2016
Evaluating the impact of an indication-based, patient-specific prescribing tool on prescribing errors in paediatrics:
Calandra Feather1,2,3, Nicholas Appelbaum4,3, Jacqueline Le Geyt2
1Dosium Holdings Limited, London, UK c.feather@imperial.ac.uk.
Insights
A new prescribing tool significantly reduced medication errors in paediatric care, cutting error rates by 83%. This patient-specific tool improved accuracy in both emergency and inpatient settings, enhancing child safety.
Area of Science:
- Medical Informatics
- Paediatric Pharmacology
- Patient Safety
Background:
- Medication errors are a significant challenge in pediatric prescribing due to complex dosing and formulations.
- Accurate medication administration is critical for child safety in healthcare settings.
Purpose of the Study:
- To evaluate the impact of an indication-based, patient-specific prescribing tool on medication errors.
- To assess the tool's effectiveness in paediatric emergency and inpatient environments.
Main Methods:
- A non-randomized, before-and-after study design was employed at a London tertiary teaching hospital.
- Manual review of 1808 medication orders (1567 standard, 241 intervention-supported) against established guidelines.
- Statistical analysis, including logistic regression, assessed error rate reduction.
Main Results:
- The intervention reduced the overall prescribing error rate from 7.14% to 1.2% (83% reduction in odds).
- Significant error reductions were observed in both the paediatric emergency department (PED) and general paediatric ward.
- Errors with the tool were linked to prescriber deviation, not tool inaccuracy.
Conclusions:
- The indication-based prescribing tool is associated with substantially lower paediatric prescribing error rates.
- Future research should focus on prescriber adherence, system integration, and user experience.
Background:
Medication errors remain a major challenge in paediatric prescribing owing to the complexities of weight-based dosing, age-specific formulations and the need for precise calculations. This study examines the association of an indication-based, patient-specific prescribing tool with prescribing errors in paediatric emergency and inpatient settings.
Methods:
A non-randomised, before-and-after study was conducted at a London tertiary teaching hospital. Prescribing errors were assessed before and after implementing the intervention in the paediatric emergency department (PED) and a general paediatric ward. Errors were identified through manual review of medication orders against predefined criteria based on the British National Formulary for Children and local prescribing guidelines. Dose errors were defined as deviations of ±10% from recommended ranges, with deviations ≥25% categorised as major. Statistical analysis included descriptive comparisons, logistic regression and intention to treat analysis to assess the effect associated with the intervention.
Results:
A total of 1808 medication orders were reviewed, including 1567 standard practice orders and 241 intervention-supported orders. When the intervention was used, the overall prescribing error rate was 1.2%, compared with 7.14% in the control orders, representing an 83% reduction in the odds of error (OR 0.17). In the general paediatric ward, errors reduced from 9.1% to 1.1% (OR 0.11), while in PED, error rates declined from 4.9% to 1.4% (OR 0.27). Errors that occurred when using the intervention were attributed to prescriber deviation from system recommendations rather than inaccuracies within the tool itself.
Conclusions:
These findings suggest that use of the intervention is associated with significantly lower odds of a prescribing error occurring in paediatric settings. Future work should focus on optimising prescriber adherence, enhancing system integration into clinical workflows and exploring economic and user-experience outcomes to maximise impact.
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