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Patterns of preadmission medication use among hospitalized children
Insights
Pediatric patients frequently use multiple medications before hospitalization, with significant use observed in those with cancer or chronic conditions. Drug usage patterns evolved during the study period.
Area of Science:
- Pediatric Pharmacology
- Drug Utilization Research
- Hospital Medicine
Background:
- Understanding pre-hospitalization medication use is crucial for managing pediatric patients.
- Previous studies have not comprehensively detailed medication patterns in this demographic.
Purpose of the Study:
- To analyze medication use patterns in pediatric patients prior to hospital admission.
- To identify trends and changes in drug utilization over time.
Main Methods:
- Retrospective review of medical records for 3,487 infants and children.
- Data collected from the Pediatric Drug Surveillance Program between 1974 and 1979.
- Analysis of pre-admission drug use based on diagnoses and demographics.
Main Results:
- Median pre-admission drug use was 3.5 medications.
- 6% reported no pre-admission drugs; 10% reported ten or more.
- Highest drug use seen in cancer patients, those with chronic diseases, and neonates in ICUs.
Conclusions:
- Substantial medication use occurs in pediatric patients before hospital admission.
- Significant shifts in the utilization of specific drugs were observed over the study period.
- Preadmission medication data is vital for optimizing pediatric inpatient care.
Abstract:
To determine patterns of medication use prior to hospital admission, we reviewed records of 3,487 infants and children monitored by the Pediatric Drug Surveillance Program. Subjects were admitted to selected monitored wards at the Children's Hospital Medical Center and Brigham and Women's Hospital between 1974 and 1979. The median number of drugs taken in the three months prior to admission was 3.5; 220 children (6%) reported taking no preadmission drugs, and 351 (10%) reported taking ten or more drugs. Preadmission drug use was highest in patients with cancer and children with chronic diseases (such as cystic fibrosis), and use was also high among infants transferred to a referral neonatal ICU. The most common preadmission medications for selected discharge diagnoses and indications are presented. In addition, review of the data revealed changes in the use of specific drugs (chloramphenicol, ampicillin, amoxicillin, Dimetapp, and cimetidine) over the study period. These data suggest that there is substantial use of medications by pediatric patients prior to hospital admission and that the nature of such drug use changes over time.