Off-Label Manipulation of Paediatric Medication Remains a Challenge in Clinical Practice: An Observational Study

Area of Science:

• Pediatric pharmacology
• Medication safety
• Pharmaceutical care

Background:

• Off-label medication manipulation is common in pediatric settings.
• Standardized protocols for manipulating medications are often lacking.

Purpose of the Study:

• To observe and document methods of off-label medication manipulation on Norwegian pediatric wards.
• To assess adherence to guidelines and safety procedures during medication manipulation.

Main Methods:

• Prospective observational study conducted on five pediatric wards across four hospitals.
• Data collected via a digital form over a 41-day period (October 2023 - May 2024).

Main Results:

• 31 instances of off-label medication manipulation were observed.
• Tablets (71%) were the most frequently manipulated dosage form, often dispersed in water for administration or dose extraction.
• Manipulation methods varied, lacked standardization, and did not consistently follow guidelines.
• Inadequate safety measures were noted, especially with potentially hazardous medications.

Conclusions:

• Significant variability exists in medication manipulation practices on pediatric wards.
• Current practices often deviate from established guidelines, posing potential risks.
• Enhanced focus on standardized procedures and safety protocols is crucial for pediatric medication management.