Evaluating the Accuracy of Drug Dosing in the Prescriptions for Children under 5 Years Old from Non Pediatric Physicians in Outpatient Clinics

Ehab Mudher Mikhael^1,

¹Department of Clinical Pharmacy, College of Pharmacy, Baghdad University

Cite this paper:
Ehab Mudher Mikhael. Evaluating the Accuracy of Drug Dosing in the Prescriptions for Children under 5 Years Old from Non Pediatric Physicians in Outpatient Clinics. American Journal of Pharmacological Sciences. 2014; 2(4):61-64. doi: 10.12691/ajps-2-4-1

Abstract

Background: Pediatric patients are more vulnerable to the effects of a medication error and may experience a more serious adverse drug reaction than adults. Dosing errors represent the most common medication errors that occur in pediatric prescriptions. This study aimed to evaluate the accuracy of drug dosing that prescribed for children under 5 years by non paediatric specialist physicians in their outpatient clinic setting. Methods: An observational study was done in a single outpatient pharmacy located in Al - Amria at Baghdad/ Iraq from May to August 2014. 24 prescriptions to children less than 5 years old from non pediatric physicians were included in this study. Each prescription will be carefully examined to collect the following data: age and weight of the patient, diagnosis of the case, the name of the prescribed drugs with their strength, dose, route of administration and frequency of usage. All children were weighted in the pharmacy. Determination of the accuracy of drug dosing for each drug in all prescriptions was based mainly on drug dosing that stated in BNF for children. Results: The percent of correct dosing in the prescriptions of non pediatricians in their outpatient clinics to children below 5 years old is only 31%. Dosing error was more common (90%) in infants than in older children (64.5%). antibiotics were the most common class of drugs that prescribed to children, while the highest percent of dosing error was related to steroid, antipyretic and analgesic prescribing. Conclusion: Dosing error is a common problem in the Rx of non pediatrician in outpatient clinics for preschool children in general and for infants specially.

Keywords:
dosing error pedatric

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References:

[1]	Jeffrey K Aronson. Medication errors: definitions and classification. Br J Clin Pharmacol. Jun 2009; 67 (6): 599–604.
[2]	Tobaiqy M, Stewart D. Exploring health professionals' experiences of medication errors in Saudi Arabia. Int J Clin Pharm. 2013 Aug; 35(4): 542-5. Epub 2013 May 7.
[3]	Patel I, Balkrishnan R. Medication error management around the globe: an overview. Indian J Pharm Sci 2010; 72: 539-45.
[4]	Stuckey ER for the American Academy of Pediatrics Committee on Drugs and American Academy of Pediatrics Committee on Hospital Care. Prevention of medication errors in the pediatric inpatient setting. Pediatrics. 2003; 112 (2): 431-436.
[5]	Miller MR, Robinson KA, Lubomski LH, et al. Medication errors in paediatric care: a systemic review of epidemiology and an evaluation of evidence supporting reducation strategy recommendations. Qual Saf Health Care. 2007; 16 (2): 116-126.
[6]	Christiansen SR, Morgan JA, Hilmas E, et al. Impact of a prescription review program on the accuracy and safety of discharge prescriptions in a pediatric hospital setting. J Pediatr Pharmacol Ther. 2008;13 (4): 226-232.
[7]	Taketomo CK, Hodding JH, Kraus DM: Pediatric & Neonatal Dosage Handbook. 18th edition. Hudson, Ohio: Lexi-Comp; 2011.
[8]	British Medical Association and the Royal Pharmaceutical Society of Great Britain. British National Formulary for children. 2011-2012 ed. UK: BMJ Publishing Group. 2011.
[9]	Otero P, Leyton A, Mariani G, Ceriani Cernadas JM; Patient Safety Committee. Medication errors in pediatric inpatients: prevalence and results of a prevention program. Pediatrics. 2008 Sep; 122 (3): e737-43.
[10]	Majed I Al-Jeraisy, Menyfah Q Alanazi and Mostafa A Abolfotouh. Medication prescribing errors in a pediatric inpatient tertiary care setting in Saudi Arabia. BMC Research Notes 2011, 4: 294.
[11]	McPhillips HA1, Stille CJ, Smith D, etal. Potential medication dosing errors in outpatient pediatrics. J Pediatr. 2005 Dec; 147 (6): 761-7.
[12]	Jost Kaufmann, Michael Laschat, Frank Wappler. Medication Errors in Pediatric Emergencies: A Systematic Analysis. Dtsch Arztebl Int 2012; 109 (38): 609-16.
[13]	Hoyle JD, Davis AT, Putman KK, etal. Medication dosing errors in pediatric patients treated by emergency medical services. Prehosp Emerg Care. 2012 Jan-Mar; 16 (1): 59-66. Epub 2011 Oct 14.
[14]	Zayed Alsulami & Sharon Conroy & Imti Choonara. Medication errors in the Middle East countries: A systematic review of the literature. Eur J Clin Pharmacol (2013) 69:995–1008.
[15]	Folli HL, Poole RL, Benitz WE, Russo JC: Medication error prevention by clinical pharmacists in two children's hospitals. Pediatrics 1987, 97: 718-22.
[16]	K A Oshikoya, H A Chukwura, O I Ojo. Evaluation of outpatient paediatric drug prescriptions in a teaching hospital in Nigeria for rational prescribing. Paediatric and Perinatal Drug Therapy, 2006; 7 (4).
[17]	Hay AD, Heron J, Ness A; ALSPAC study team. The prevalence of symptoms and consultations in pre-school children in the Avon Longitudinal Study of Parents and Children (ALSPAC): a prospective cohort study. Fam Pract. 2005 Aug; 22 (4): 367-74. Epub 2005 May 16.
[18]	Sarah Sahraoui, Oluwaranti Akiyode. Impetigo in Children and Adolescents. US Pharm. 2013; 38 (6): 68-71.
[19]	Adam L. Hersh, Daniel J. Shapiro, Andrew T. Pavia, Samir S. Shah. Antibiotic Prescribing in Ambulatory Pediatrics in the United States. Pediatrics 2011; 128 (6): 1053-1061.
[20]	Sandra Benavides, Donna Huynh, Jill Morgan, Leslie Briars. Approach to the Pediatric Prescription in a Community Pharmacy. J Pediatr Pharmacol Ther 2011; 16 (4): 298–307.
[21]	Yaffe SJ, Bierman CW, Cann HM, et al. Inaccuracies in administering liquid medication. Pediatrics. 1975; 56 (2): 327–328.
[22]	Lindell-Osuagwu L, Korhonen MJ, Saano S, Helin-Tanninen M, Naaranlahti T, Kokki H. Off-label and unlicensed drug prescribing in three paediatric wards in Finland and review of the international literature. J Clin Pharm Ther. 2009 Jun; 34 (3): 277-87.