Department of Pharmacy, Rush University Medical Center, Chicago, Illinois.
Department of Pharmacy, Rush University Medical Center, Chicago, Illinois.
Pediatr Neurol. 2023 May;142:10-15. doi: 10.1016/j.pediatrneurol.2023.01.015. Epub 2023 Feb 3.
An estimated 26% to 33% of pediatric patients have at least one medication error at hospital discharge. Pediatric patients with epilepsy may be at greater risk due to complex medication regimens and frequent hospitalizations. This study aims to quantify the proportion of pediatric patients with epilepsy experiencing medication problems after discharge and determine if medication education decreases these problems.
This was a retrospective cohort study including pediatric patients with epilepsy-related hospital admissions. Cohort 1 consisted of a control group, and cohort 2 consisted of patients who received discharge medication education, enrolled in a 2:1 ratio. The medical record was reviewed from hospital discharge to outpatient neurology follow-up to identify medication problems that occurred. The primary outcome was the difference in proportion of medication problems between the cohorts. Secondary outcomes were incidence of medication problems with harm potential, overall incidence of medication problems, and 30-day epilepsy-related readmissions.
A total of 221 patients were included (163 in the control cohort and 58 in the discharge education cohort) with balanced demographics. The incidence of medication problems was 29.4% in the control cohort and 24.1% in the discharge education cohort (P = 0.44). The most common problems were mismatched dose or direction. Medication problems with harm potential were 54.2% in the control group and 28.6% in the discharge education cohort (P = 0.131).
Medication problems and their harm potential were lower in the discharge education cohort, but the difference was not significant. This demonstrates education alone may not be enough to impact medication error rates.
据估计，26%至 33%的儿科患者在出院时至少会出现一次用药错误。由于复杂的用药方案和频繁住院，癫痫儿科患者的风险可能更高。本研究旨在量化出院后癫痫儿科患者出现用药问题的比例，并确定用药教育是否能降低这些问题。
这是一项回顾性队列研究，纳入了与癫痫相关的住院儿科患者。队列 1 为对照组，队列 2 为接受出院用药教育的患者，比例为 2:1。从出院到门诊神经科随访，对病历进行回顾，以确定发生的用药问题。主要结局是两组间用药问题比例的差异。次要结局是有潜在危害的用药问题发生率、总体用药问题发生率和 30 天内与癫痫相关的再入院率。
共纳入 221 名患者（对照组 163 名，出院教育组 58 名），两组的人口统计学特征平衡。对照组的用药问题发生率为 29.4%，出院教育组为 24.1%（P=0.44）。最常见的问题是剂量或方向不匹配。对照组用药问题有潜在危害的比例为 54.2%，出院教育组为 28.6%（P=0.131）。
尽管出院教育组的用药问题及其潜在危害较低，但差异无统计学意义。这表明仅教育可能不足以影响用药错误率。
