Author(s): Jagadeesan M, Harini R R, Balaji Chinnasami

Email(s): jagapharmd2013@gmail.com

DOI: 10.5958/0974-360X.2020.00969.5   

Address: Jagadeesan M1*, Harini R R1, Balaji Chinnasami2
1Department of Pharmacy Practice, SRM College of Pharmacy, SRM Institute of Science and Technology, Kanchipuram- 603203, Tamil Nadu, India.
2Department of Paediatrics, SRM Medical College Hospital and Research Centre, SRM Institute of Science and Technology, Kanchipuram- 603203, Tamil Nadu, India.
*Corresponding Author

Published In:   Volume - 13,      Issue - 11,     Year - 2020


ABSTRACT:
Context: Irrational utilization of medications in paediatrics become very common in clinical practice due to many factors. It is very overcome the barriers of rational prescribing to increase positive therapeutic outcomes in paediatrics. This review explores, various factors like Paediatric ethics, unlicensed/ off-label use of medicines, unavailability of suitable formulations, administration difficulties, etc., that influence in the rational prescribing in the paediatric population: Evidence Acquisition: In this review, Medline and PubMed searching engine used to extract the research articles from the year 1990 to 2019 related to rational prescribing in paediatrics. Totally 310 articles were identified and finally, 26 research articles selected based on inclusion and exclusion criteria. Results: Eight research articles concluded about irrationality in anti-biotic prescribing, five articles discussed on unlicensed/off-label use of medications. Three articles showed evidence for medication errors. Tow research articles discussed vaccine/medicine administration difficulties, paediatric ethics, management of rare diseases, utilization of orphan drugs, nutritional supplements respectively. Conclusion: It is imperative to have the contribution of trained paediatric clinical pharmacologists to promote the rational use of medicine in children. Paediatric essential medicine list must be accessible to all the caregivers with patient education leaflets, by developing the orphan drug list and training the clinicians on how to utilize these medicines might be helpful to reduce irrationality.


Cite this article:
Jagadeesan M, Harini R R, Balaji Chinnasami. Rational Prescribing Challenges in Paediatrics: A Evidence Based Review. Research J. Pharm. and Tech. 2020; 13(11):5551-5556. doi: 10.5958/0974-360X.2020.00969.5


REFERENCE:
1.    World Health Organization. The Rational Use of Drugs - Report of the Conference of Experts, Nairobi 25-29 November1985. Available from: https://apps.who.int/medicinedocs/en/m/abstract/ Js17054e/.
2.    World Health Organization. WHO Policy Perspectives on Medicines. Promoting rational use of medicines: core components. Geneva: WHO. Available from:2002.http://apps.who.int/ medicinedocs/en/d/Jh3011e/.
3.    Yaffe SJ, Aranda JV, editors. Neonatal and pediatric pharmacology: therapeutic principles in practice. Lippincott Williams and Wilkins; 2010.
4.    T. P. G. M. de Vries, R. H. Henning, H. V. Hogerzeil, D. A. Fresle. World Health Organization. Guide to Good Prescribing, Geneva, 1997. Available from: https://apps.who.int/medicinedocs/ pdf/whozip23e/whozip23e.pdf.
5.    Bavdekar SB. Pediatric clinical trials. Perspect Clin Res 2013; 4:89.
6.    Dunne J, Rodriguez WJ, Murphy MD, Beasley BN, Burckart GJ, Filie JD, Lewis LL, Sachs HC, Sheridan PH, Starke P, Yao LP. Extrapolation of adult data and other data in pediatric drug-development programs. Pediatrics2011; 128:e1242-9.
7.    Licensing Medicines for children. Joint report of the British Paediatric Association and the Association of the British Pharmaceutical Industry. London: BPA; 1996.
8.    Nielsen ES, Hellfritzsch M, Sørensen MJ, Rasmussen H, Thomsen PH, Laursen T. Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic. Eur Child Adolesc Psychiatry2016; 25:25-31.
9.    Santos DB, Clavenna A, Bonati M, Coelho HL. Off-label and unlicensed drug utilization in hospitalized children in Fortaleza, Brazil. Eur. J. Clin. Pharmacol2008; 64:1111.
10.    Conroy S, Choonara I, Impicciatore P, Mohn A, Arnell H, Rane A, Knoeppel C, Seyberth H, Pandolfini C, Raffaelli MP, Rocchi F. Survey of unlicensed and off label drug use in paediatric wards in European countries. Bmj. 2000; 320:79-82.
11.    Conroy S, McIntyre J, Choonara I. Unlicensed and off label drug use in neonates. Arch. Dis. Child. 1999; 80:F142-5.
12.    Turner S, Longworth A, Nunn AJ, Choonara I. Unlicensed and off label drug use in paediatric wards: prospective study. Bmj. 1998; 316:343-5.
13.    Boztepe H, Özdemir H, Karababa Ç, Yıldız Ö. Difficulties experienced during preparation and administration of oral drugs. Turkish J. Pediatr.2014; 49:231.
14.    Flanagan-Klygis EA, Sharp L, Frader JE. Dismissing the family who refuses vaccines: a study of pediatrician attitudes. Arch Pediatr. Adolesc Med. 2005; 159:929-34.
15.    Cockburn J, Pit S. Prescribing behaviour in clinical practice: patients' expectations and doctors' perceptions of patients' expectations—a questionnaire study. Bmj. 1997; 315:520-3.
16.    Little P, Dorward M, Warner G, Stephens K, Senior J, Moore M. Importance of patient pressure and perceived pressure and perceived medical need for investigations, referral, and prescribing in primary care: nested observational study. Bmj. 2004; 328:444.
17.    Degli Atti ML, Massari M, Bella A, Boccia D, Filia A, Salmaso S, SPES Study Group. Clinical, social and relational determinants of paediatric ambulatory drug prescriptions due to respiratory tract infections in Italy. Eur. J. Clin. Pharmacol. 2006; 62:1055.
18.    Pandit S, Shah U, Kirby DJ, Nunn T, Tuleu C. Inappropriate oral formulations and information in paediatric trials. Arch. Dis. Child.2010; 95:754-6.
19.    Abula T, Desta Z. Prescribing pattern of drugs in pediatric wards of three Ethiopian hospitals. Ethiop J Health Dev. 1999; 13:135-40.
20.    Buckley MS, Erstad BL, Kopp BJ, Theodorou AA, Priestley G. Direct observation approach for detecting medication errors and adverse drug events in a pediatric intensive care unit. Pediatr Crit Care Med. 2007; 8:145-52.
21.    Cimino MA, Kirschbaum MS, Brodsky L, Shaha SH. Assessing medication prescribing errors in pediatric intensive care units. Pediatr Crit Care Med. 2004; 5:124-32.
22.    Kozer E, Scolnik D, Macpherson A, Keays T, Shi K, Luk T, Koren G. Variables associated with medication errors in pediatric emergency medicine. Pediatrics. 2002; 110:737-42.
23.    Laxminarayan R, Duse A, Wattal C, Zaidi AK, Wertheim HF, Sumpradit N, Vlieghe E, Hara GL, Gould IM, Goossens H, Greko C. Antibiotic resistance—the need for global solutions. Lancet Infect Dis. 2013; 13:1057-98.
24.    Sharma S, Bowman C, Alladin-Karan B, Singh N. Antibiotic prescribing patterns in the pediatric emergency department at Georgetown Public Hospital Corporation: a retrospective chart review. BMC Infect Dis. 2016; 16:170.
25.    Cole CP, James PB, Kargbo AT. An evaluation of the prescribing patterns for under-five patients at a Tertiary Paediatric Hospital in Sierra Leone. J. Basic Clin. Pharm.2015; 6:109.
26.    Sharma M, Damlin A, Pathak A, Lundborg CS. Antibiotic prescribing among pediatric inpatients with potential infections in two private sector hospitals in Central India. PLoS One. 2015; 10:e0142317.
27.    Al-Niemat SI, Aljbouri TM, Goussous LS, Efaishat RA, Salah RK. Antibiotic prescribing patterns in outpatient emergency clinics at Queen Rania Al Abdullah II Children's Hospital, Jordan, 2013. Oman Med. J.2014; 29:250.
28.    Evripidou I, Evripidou A, Latsou D, Toska A, Koliou M, Geitona M. Antibiotic Prescription Practices of Pediatricians In Hospital Care In Cyprus. Value in Health. 2015; 18:A564-5.
29.    Mezgebe HB, Tadesse B, Legesse B. Antibiotics prescribing pattern in pediatric unit of Ayder referral hospital, Tigray region, Northern Ethiopia. J SCI IND RES INDIA. 2015; 4(2):57-60.
30.    TasawerBaig M, Akbar Sial A, Huma A, Ahmed M, Shahid U, Syed N. Irrational antibiotic prescribing practice among children in critical care of tertiary hospitals. Pak. J. Pharm. Sci. 2017;2:30.
31.    Palikhe N. Prescribing pattern of antibiotics in pediatric hospital of Kathmandu valley. J Nepal Health Res Counc.2008.
32.    Agalu A, Mekonnen H. Drug prescribing practice in a pediatrics ward in Ethiopian. Int Res J Pharm Pharmacol. 2012; 2:132-8.
33.    Hift RJ, Meissner PN. An analysis of 112 acute porphyric attacks in Cape Town, South Africa: evidence that acute intermittent porphyria and variegate porphyria differ in susceptibility and severity. Medicine. 2005; 84:48-60.

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