Investigation on the use of high-alert medications for children in prescriptions
10.3760/cma.j.cn114015-20211008-01046
- VernacularTitle:基于处方的儿童高警示药品使用情况调查
- Author:
Chunxiang WANG
1
;
Xuelian HU
;
Zhenzhi LI
;
Shujie LIU
;
Yuling LIU
;
Chunming MENG
;
Gang XUE
Author Information
1. 首都医科大学附属北京妇产医院怀柔妇幼保健院药剂科，北京 101400
- Publication Type:Journal Article
- Keywords:
Medication errors;
High-alert medications;
Child
- From:
Adverse Drug Reactions Journal
2021;23(11):577-583
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To understand the usage status of high-alert medicines (HAM) for children in outpatient and emergency prescriptions and inpatient medication orders at department of pediatric.Methods:All outpatient and emergency prescriptions and inpatient medication orders in patients with an age of <18 years between July 1, 2016 and June 30, 2018 in Huairou Maternal and Child Health Hospital Affiliated to Beijing Obstetrics and Gynecology Hospital, Capital Medical University were collected. According to the List of High-Alert Medications for the Chinese Children, the use of HAM for children in prescriptions and medication orders was analyzed retrospectively. Results:A total of 297 968 prescriptions and medication orders were collected in the study, including 270 024 outpatient and emergency prescriptions (90.62%) and 27 944 inpatient medication orders (9.38%). There were 162 521 prescriptions (54.54%) involving male children and 135 447 (45.46%) involving female children with an age of (4±3) years, ranged 0-17 years. The number of drugs included in each prescription was (2±1), ranged 1-9. Of the 297 968 prescriptions and medication orders, 23 476 (7.88%) involved HAM for children. The proportion of prescriptions containing HAM for children in outpatient and emergency prescriptions was significantly higher than that in inpatient medication orders [7.92% (21 381/270 024) vs. 7.50% (2 095/27 944), P=0.013]; the proportion of prescriptions and medication orders containing HAM for children in Surgery Department [32.84% (1 220/3 715)] was significantly higher than that in Medicine Department [8.17% (22 043/269 777)] and other departments [0.87% (213/24 476)], and the difference was statistically significant (all P<0.001). The 23 476 prescriptions involved 13 categories and 42 kinds of HAM for children and the total frequency of HAM for children was 26 084. The top 3 drug categories that most frequently used were traditional Chinese medicine injections (8 694, 33.33%), antipyretic analgesic and anti-inflammatory drugs (7 505, 28.77%), and anti-infective drugs (4 011, 15.38%); the top 10 HAM for children that most frequently used were paracetamol, Yanhuning injection (炎琥宁注射液), Xiyanping injection (喜炎平注射液), vitamin K 1, vidarabine, tetanus antitoxin, penicillins, phenobarbital, promethazine injections, and heparin. Adverse events occurred in 9 children due to medication errors of HAM for children, which were all grade E, and the drugs involved were Xiyanping injection, paracetamol, and vitamin K 1 injection. Conclusions:HAM for children was commonly used, among which the traditional Chinese medicine injection-related HAM was used more, and the proportion of prescriptions containing HAM for children was higher in departments of outpatient, emergency, and surgery. Medication errors related to HAM for children may lead to serious adverse events, so the management of HAM for children should be strengthened.
