Satir Aylin N, Pfiffner Miriam, Meier Christoph R, Caduff Good Angela
Department of Hospital Pharmacy, University Children's Hospital Zurich, Zurich, Switzerland.
Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Drugs Real World Outcomes. 2023 Dec;10(4):619-629. doi: 10.1007/s40801-023-00392-0. Epub 2023 Oct 13.
There are only limited data on drug utilization patterns in pediatric inpatients, especially on general wards. The aim of the study was to describe prescribing patterns and their associations with prescribing errors in a university children's hospital in the German-speaking part of Switzerland.
This was a subanalysis of a retrospective single-center observational study. Patient characteristics and drug use of 489 patients with 2693 drug prescriptions were associated with prescribing errors. Drugs were categorized by the Anatomic Therapeutic Chemical Classification System (ATC), patients were categorized by age group according to European Medicines Agency guidelines, and prescribing errors were analyzed by type [Pharmaceutical Care Network Europe (PCNE) classification] and severity of error [adapted National Coordinating Council for Medication Error Reporting (NCC MERP) index].
The most frequently prescribed ATC classes were nervous system (N) (42.6%), alimentary system (A) (15.6%), and anti-infective drugs (J) (10.7%). Eighty-two percent of patients were prescribed an analgesic. Most drugs were prescribed for oral (47%) or intravenous (32%) administration, but the rectal route was also frequent (10%). The most frequently prescribed drugs were paracetamol, metamizole, and ibuprofen. The high number of metamizole prescriptions (37% of patients were prescribed metamizole) is typical for German-speaking countries. Older pediatric patients were prescribed more drugs than younger patients. A statistically significant difference was found in the rate of potentially harmful errors across age groups and for gender; children between 2 and 11 years had a higher rate of potentially harmful errors than infants under 2 years (p = 0.029) and female patients had a higher rate of potentially harmful errors than male patients (p = 0.023). Recurring errors were encountered with certain drugs (nalbuphine, cefazolin).
Our study provides insight into prescribing patterns on pediatric general wards in a university children's hospital in Switzerland and highlights some areas for future research. Especially, the higher risk for prescribing errors among female pediatric patients needs further investigation.
关于儿科住院患者，尤其是普通病房患者的药物使用模式的数据有限。本研究的目的是描述瑞士德语区一家大学儿童医院的处方模式及其与处方错误的关联。
这是一项回顾性单中心观察性研究的子分析。489例患者的2693张药物处方的患者特征和药物使用情况与处方错误相关。药物按照解剖治疗学化学分类系统（ATC）进行分类，患者根据欧洲药品管理局指南按年龄组进行分类，处方错误按类型[欧洲药学保健网络（PCNE）分类]和错误严重程度[改编的国家用药错误报告协调委员会（NCC MERP）指数]进行分析。
最常开具的ATC类别为神经系统（N）（42.6%）、消化系统（A）（15.6%）和抗感染药物（J）（10.7%）。82%的患者开具了镇痛药。大多数药物通过口服（47%）或静脉注射（32%）给药，但直肠给药途径也很常见（10%）。最常开具的药物是对乙酰氨基酚、安乃近和布洛芬。安乃近的处方数量较多（37%的患者开具了安乃近），这在德语国家很典型。年龄较大的儿科患者比年龄较小的患者开具的药物更多。在各年龄组和性别之间，潜在有害错误的发生率存在统计学显著差异；2至11岁的儿童比2岁以下的婴儿有更高的潜在有害错误发生率（p = 0.029），女性患者比男性患者有更高的潜在有害错误发生率（p = 0.023）。某些药物（纳布啡、头孢唑林）存在反复出现的错误。
我们的研究提供了对瑞士一家大学儿童医院儿科普通病房处方模式的见解，并突出了一些未来研究的领域。特别是，女性儿科患者处方错误风险较高这一情况需要进一步研究。
