Epidemiology and potential associated risk factors of drug-related problems in hospitalised children in the United Kingdom and Saudi Arabia.
OBJECTIVE
Drug-related problems (DRP) are "an event or circumstance involving drug therapy that actually or potentially interferes with the desired health outcome". The extent and characteristics of DRPs in children in the UK and the Kingdom of Saudi Arabia (KSA) are unknown. Our aim was to determine the epidemiology of and identify risk factors for DRPs in hospitalised children.


METHODS
A prospective cohort study was carried out in children aged 0-18 years, admitted to the medical ward, paediatric intensive care unit (PICU) and neonatal intensive care unit (NICU) during a 3-month period in two hospitals. Patients' charts, medical records and laboratory data were reviewed daily to identify DRPs; their preventability and severity were assessed. Logistic regression was used to analyse the potential risk factors associated with DRP incidence.


RESULTS
Seven hundred and thirty-seven children (median age 2.3 years, interquartile range 6 months to 8 years, 58.1% male) were included. Three hundred and thirty-three patients suffered from 478 DRPs. Overall DRP incidence was 45.2% (95% CI, 41.5-48.8); KSA (51.1%; 95% CI, 45.8-56.3), UK (39.4%; 95% CI, 34.4-44.6). Incidence was highest in the PICU (59.7%; 95% CI, 47.0-71.5). Dosing problems were the most frequently reported DRPs (n = 258, 54%). 80.3% of DRP (n = 384) cases were preventable; 72.2% (n = 345) of DRPs were assessed as minor; 27% (n = 129) as moderate. Number of prescriptions and type of admission (transferred) were potential risk factors for DRP occurrence in children.


CONCLUSIONS
Drug-related problems were common in the hospitalised children in this study; the most frequent were dosing problems and drug choice problems; the majority of them were preventable. Polypharmacy and transferred admission (another hospital or ward) were potential risk factors. To improve prescribing practices and minimise the risk of DRPs in hospitalised children, paediatric pharmacology and pharmacotherapy are important in medical education.
Centre for Paediatric Pharmacy Research, UCL School of Pharmacy, 29-39 Brunswick Square, London, WC1N 1AX, UK.
Asia N
AN
Rashed
Antje
A
Neubert
Stephen
S
Tomlin
John
J
Jackman
Hani
H
Alhamdan
Adnan
A
AlShaikh
Ahmed
A
Attar
Mohammed
M
Aseeri
Lynda
L
Wilton
Ian C K
IC
Wong
D002648:Child; D002675:Child, Preschool; D017723:Drug Utilization Review / Q000706:statistics & numerical data; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data*; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D008297:Male; D019338:Polypharmacy; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D006113:United Kingdom / Q000453:epidemiology