Bekele Firomsa, Bereda Gudisa, Tamirat Lalisa, Geleta Bonsa Amsalu, Jabessa Dabala
Department of Pharmacy, College of Health Science, Mettu University, Mettu, Ethiopia.
Department of Nursing, College of Health Science, Mettu University, Mettu, Ethiopia.
Ann Med Surg (Lond). 2021 Sep 7;70:102827. doi: 10.1016/j.amsu.2021.102827. eCollection 2021 Oct.
The rate of medication related problems is high in developing countries due to the complexity of pediatrics medication management. Pediatric population should have their own dosage regimens. The pediatric dosage regimens were derived from the adult dose that might lead to sudden reach of sub or supra-therapeutic doses. As the result, the medication therapy management is difficult in this populations. Despite this, a scanty of studies were conducted on medication related problems among pediatric populations. Therefore, this study examined the prevalence and risk factors for the occurrence of the medication related problems among patients admitted to pediatric ward of Mettu karl referral hospital.
The pediatric population who were received the pharmacotherapy for their disease was observed and followed for the occurrences of medication related problems at pediatric wards of Mettu karl referral hospital from February 12, 2020 to February 24, 2021. Patients whose age was less than or equal to 18 years and who were on drug therapy or who needs drug therapy during study period were included. The possibility of adverse drug reactions developed from the drug was assessed by using the Naranjo scale. Multivariable logistic regression analysis was used to determine the predictors of medication related problems.
Over the study period, a total of 189 pediatric populations were included. Among these, 115 (60.8%) were males, and the mean age of the patients was 1.4339 ± 0.864 years. The mediciation related problems was found among 121(64.01%) of pediatric patients. Among seven types of drug therapy problems unnecessary drug therapy, need additional drug therapy, ineffective drug therapy and dose too high were the most predominantly occured DRP that accounted 74 (27.72%), 67 (25.09%), 43 (16.10%), 36 (13.48%), respectively. The mean number of hospital stay was 4.29 days with minimum and maximum stay of 2 and 9 days and antibiotics 364(51.3%) were the most common class of drugs that was associated with drug related problems. Being a neonate (AOR = 1.48, 95CI%: 1.69-7.42, P = <0.001), hospital stay greater than or equal to seven days (AOR = 1.98, 95CI%: 2.471-12.644, P = 0.016), and the presence of co-morbidity(AOR = 2.507, 95CI%: 3.270-4.949, P = 0.080) were the predictors of the medication related problems.
The prevalence of medication-related problems in pediatrics patient was found to be high. Being neonatal, prolonged hospital stay and the presence of a multiple disease were the predictors of medication-related problems in pediatric patients. Therefore special attention should be given for newborns, prolonged hospital stay and patients having co-morbidity. Besides this, the drug information service and the patients round activity should be started by clinical pharmacist to decrease the occurences of any preventable medication related problems.
由于儿科药物管理的复杂性,发展中国家与药物相关问题的发生率较高。儿科人群应有自己的给药方案。儿科给药方案源自成人剂量,这可能导致亚治疗剂量或超治疗剂量的突然达到。因此,在这一人群中进行药物治疗管理很困难。尽管如此,针对儿科人群中与药物相关问题的研究却很少。因此,本研究调查了梅图卡尔转诊医院儿科病房收治患者中与药物相关问题的发生率及危险因素。
观察并随访了2020年2月12日至2021年2月24日在梅图卡尔转诊医院儿科病房接受药物治疗的儿科人群中与药物相关问题的发生情况。纳入年龄小于或等于18岁、在研究期间接受药物治疗或需要药物治疗的患者。使用纳伦霍量表评估药物产生药物不良反应的可能性。采用多变量逻辑回归分析确定与药物相关问题的预测因素。
在研究期间,共纳入189名儿科人群。其中,115名(60.8%)为男性,患者的平均年龄为1.4339±0.864岁。在121名(64.01%)儿科患者中发现了与药物相关的问题。在七种药物治疗问题中,不必要的药物治疗、需要额外的药物治疗、无效的药物治疗和剂量过高是最主要发生的药物相关问题,分别占74例(27.72%)、67例(25.09%)、43例(16.10%)、36例(13.48%)。平均住院天数为4.29天,最短和最长住院天数分别为2天和9天,抗生素364例(51.3%)是与药物相关问题最常见的药物类别。新生儿(比值比=1.48,95%置信区间:1.69 - 7.42,P = <0.001)、住院天数大于或等于7天(比值比=1.98,95%置信区间:2.471 - 12.644,P = 0.016)以及存在合并症(比值比=2.507,95%置信区间:3.270 - 4.949,P = 0.080)是与药物相关问题的预测因素。
发现儿科患者中与药物相关问题的发生率较高。新生儿、住院时间延长和患有多种疾病是儿科患者与药物相关问题的预测因素。因此,应特别关注新生儿、住院时间延长和患有合并症的患者。除此之外,临床药师应开展药物信息服务和查房活动,以减少任何可预防的与药物相关问题的发生。