Nadeshkumar Abarna, Sathiadas Gitanjali, Pathmeswaran Arunasalam, Ranganathan Shalini Sri
Department of Allied Health Sciences, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.
Department of Paediatrics, Faculty of Medicine, University of Jaffna, Sri Lanka.
WHO South East Asia J Public Health. 2019 Apr;8(1):42-49. doi: 10.4103/2224-3151.255349.
Owing to lack of indicators, researchers are compelled to use non-specific indicators to assess rational use of medicines in children. Thus, paediatric-specific issues are poorly described. This study aims to develop a set of indicators to describe rational use of oral dosage forms of medicines given to children.
A modified RAND/UCLA Appropriateness Method was used. A comprehensive draft list of 40 indicators was compiled, based on the results of a literature review. Twelve experts rated these indicators in two rounds, using a nine-point Likert scale, first in an online survey, for clarity, necessity and scientific merit, and secondly in a face-to-face meeting, for necessity, feasibility and predictive value. An overall panel median score of ≥7 and agreement within the experts were used in indicators. The indicators were ranked independently by the research team and a final list of indicators was prepared. These indicators were pilot-tested for acceptability and interrater reliability.
Nine prescribing indicators, such as weight, appropriate dose and age-appropriate dosage form; five dispensing indicators, such as adequacy of labelling and inappropriate manipulation by pharmacists; and five administration indicators, such as inappropriate manipulation by parents and full completion of dose, were finalized in the second round.
This novel approach has provided a set of indicators to describe the use of oral dosage forms of medicines given to children, which can be used by researchers as a supplement to the World Health Organization's drug use indicators when investigating rational use of medicines in children.
由于缺乏相关指标，研究人员不得不使用非特异性指标来评估儿童用药的合理性。因此，儿童特有的问题描述得很不完善。本研究旨在制定一套指标，以描述儿童口服剂型药物的合理使用情况。
采用改良的兰德/加州大学洛杉矶分校适宜性方法。根据文献综述结果，编制了一份包含40项指标的综合草案清单。12位专家分两轮对这些指标进行评分，采用九点李克特量表，第一轮通过在线调查，评估指标的清晰度、必要性和科学价值，第二轮通过面对面会议，评估指标的必要性、可行性和预测价值。指标采用专家小组总体中位数得分≥7且专家意见一致的标准。研究团队对指标进行独立排序，并编制了最终的指标清单。对这些指标进行了可接受性和评分者间信度的预测试。
第二轮确定了9项处方指标，如体重、合适剂量和适合年龄的剂型；5项调配指标，如标签是否充分以及药剂师的不当操作；以及5项给药指标，如家长的不当操作和剂量的完全服用。
这种新方法提供了一套指标来描述儿童口服剂型药物的使用情况，研究人员在调查儿童用药合理性时可将其作为世界卫生组织药物使用指标的补充。
