Implementation of Clinical Pharmacy Activities in Pediatric Cardiology Department: A French Observational Study

Pediatric cardiology is a medico-surgical specialty using high-risk medications such as anticoagulants, beta-blockers and antiarrhythmics. Most of the time, the patients are less than 6 years old; therefore they must take oral medications available in multi-dose bottles. Those make them particularly vulnerable. Clinical pharmacy activities as medication review and pharmaceutical interviews can help to reduce medication-related errors. This study aimed, for the first time, to assess the feasibility of implementing clinical pharmacy services in a pediatric cardiology department. From January 2022 to December 2024, clinical pharmacy activities were implemented in a university hospital in France, including hospital medication review to identify and resolve medication-related problems, as well as pharmaceutical interviews to inform and educate patients and their caregivers about home medication usage. During 3 years, over 592 working days, 5 848 medication reviews were performed for 2267 patients. A total of 564 medication-related problems (9.6% of prescriptions) were identified, most commonly involving anti-infective agents. Of these, 44.1% were related to dosage, and 67.7% led to changes in prescriptions. Additionally, 409 pharmaceutical interviews were conducted before discharge. Medication review helped secure hospital prescriptions, with several identified issues considered clinically significant. Educational interviews from pharmacist to patients and/or their parents emerged as a promising strategy to secure the utilization of high-risk medications at home. This high-risk moment of the care pathway needs to be prioritized and especially for vulnerable populations such as pediatrics.