Centre for Paediatric Pharmacy Research, UCL School of Pharmacy, 29-39 Brunswick Square, London, WC1N 1AX, UK.
Eur J Clin Pharmacol. 2012 Dec;68(12):1657-66. doi: 10.1007/s00228-012-1302-x. Epub 2012 May 30.
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.
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.
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.
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.
药物相关问题（DRP）是“涉及药物治疗的事件或情况，实际上或潜在地干扰了预期的健康结果”。在英国和沙特阿拉伯王国（KSA），儿童中 DRP 的程度和特征尚不清楚。我们的目的是确定住院儿童中 DRP 的流行病学，并确定其危险因素。
在两家医院的 3 个月期间，对 0-18 岁的住院儿童进行了前瞻性队列研究。每天审查患者的图表、病历和实验室数据以确定 DRP；评估其可预防和严重程度。使用逻辑回归分析与 DRP 发生率相关的潜在危险因素。
共纳入 737 名儿童（中位年龄 2.3 岁，四分位距 6 个月至 8 岁，58.1%为男性）。333 名患者患有 478 种 DRP。总体 DRP 发生率为 45.2%（95%CI，41.5-48.8）；KSA（51.1%；95%CI，45.8-56.3），英国（39.4%；95%CI，34.4-44.6）。发生率最高的是儿科重症监护病房（59.7%；95%CI，47.0-71.5）。剂量问题是报告最多的 DRP（n=258，54%）。80.3%的 DRP（n=384）病例是可预防的；72.2%（n=345）的 DRP 被评估为轻度；27%（n=129）为中度。处方数量和入院类型（转院）是儿童发生 DRP 的潜在危险因素。
本研究中，住院儿童中 DRP 很常见；最常见的是剂量问题和药物选择问题；其中大多数是可以预防的。多药治疗和转院（另一家医院或病房）是潜在的危险因素。为了改善处方实践并最大限度地降低住院儿童发生 DRP 的风险，儿科药理学和药物治疗在医学教育中很重要。
