POPI (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions): development of a tool to identify inappropriate prescribing

Sonia Prot-Labarthe, Thomas Weil, François Angoulvant, Rym Boulkedid, Corinne Alberti, Olivier Bourdon, Sonia Prot-Labarthe, Thomas Weil, François Angoulvant, Rym Boulkedid, Corinne Alberti, Olivier Bourdon

Abstract

Introduction: Rational prescribing for children is an issue for all countries and has been inadequately studied. Inappropriate prescriptions, including drug omissions, are one of the main causes of medication errors in this population. Our aim is to develop a screening tool to identify omissions and inappropriate prescriptions in pediatrics based on French and international guidelines.

Methods: A selection of diseases was included in the tool using data from social security and hospital statistics. A literature review was done to obtain criteria which could be included in the tool called POPI. A 2-round-Delphi consensus technique was used to establish the content validity of POPI; panelists were asked to rate their level of agreement with each proposition on a 9-point Likert scale and add suggestions if necessary.

Results: 108 explicit criteria (80 inappropriate prescriptions and 28 omissions) were obtained and submitted to a 16-member expert panel (8 pharmacists, 8 pediatricians hospital-based -50%- or working in community -50%-). Criteria were categorized according to the main physiological systems (gastroenterology, respiratory infections, pain, neurology, dermatology and miscellaneous). Each criterion was accompanied by a concise explanation as to why the practice is potentially inappropriate in pediatrics (including references). Two round of Delphi process were completed via an online questionnaire. 104 out of the 108 criteria submitted to experts were selected after 2 Delphi rounds (79 inappropriate prescriptions and 25 omissions).

Discussion conclusion: POPI is the first screening-tool develop to detect inappropriate prescriptions and omissions in pediatrics based on explicit criteria. Inter-user reliability study is necessary before using the tool, and prospective study to assess the effectiveness of POPI is also necessary.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Workflow for the validation of…
Figure 1. Workflow for the validation of POPI.
*An item involving codeine was removed subsequent to the validation of the propositions included in POPI, following the revelation of new contraindications for this drug in children under 12 years old . N: Number of items; n: number of panelists.

References

    1. WHO | Medicines: rational use of medicines (n.d.). WHO. Available: . Accessed 2014 May 12.
    1. Choonara I (2013) Rational prescribing is important in all settings. Arch Dis Child 98: 720–720 10.1136/archdischild-2013-304559
    1. Risk R, Naismith H, Burnett A, Moore SE, Cham M, et al. (2013) Rational prescribing in paediatrics in a resource-limited setting. Arch Dis Child 98: 503–509 10.1136/archdischild-2012-302987
    1. Inappropriate Prescribing - MeSH - NCBI (n.d.). Available: . Accessed 2012 June 18.
    1. Legrain S, others (2005) Consommation médicamenteuse chez le sujet âgé. Consomm Prescr Iatrogénie Obs. Available: . Accessed 2012 June 17.
    1. Fick D, Semla T, Beizer J, Brandt N (2012) American Geriatrics Society Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults - J Am Geriatrics Society - 2012.pdf. J Am Geriatr Soc 60: 616–631 10.1111/j.1532-5415.2012.03923.x
    1. Gallagher P, Ryan C, Kennedy J, O’Mahony D (2008) STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). Consensus validation. Int J Clin Pharmacol Ther 46: 72–83.
    1. Gallagher P, O’Mahony D (2008) STOPP (Screening Tool of Older Persons’ potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers’ criteria. Age Ageing 37: 673–679 10.1093/ageing/afn197
    1. Gallagher P, O’Connor M, O’Mahony D (2011) Prevention of Potentially Inappropriate Prescribing for Elderly Patients: A Randomized Controlled Trial Using STOPP/START Criteria. Clin Pharmacol Ther 89: 845–854 10.1038/clpt.2011.44
    1. Prot-Labarthe S, Vercheval C, Angoulvant F, Brion F, Bourdon O (2011) «POPI; pédiatrie: omissions et prescriptions inappropriées». Outil d’identification des prescriptions inappropriées chez l’enfant. Arch Pédiatrie Organe Off Sociéte Fr Pédiatrie 18: 1231–1232 10.1016/j.arcped.2011.08.019
    1. Affection de longue durée (ALD) (n.d.). Available: . Accessed 2012 June 18.
    1. Thériaque (n.d.). Available: . Accessed: 2012 July 3.
    1. Thomson Healthcare Products (n.d.). Available: . Accessed: 2012 July 3.
    1. Taketomo CK, Hodding JH, Kraus DM (2011) Pediatric & neonatal dosage handbook: a comprehensive resource for all clinicians treating pediatric and neonatal patients. Hudson, Ohio; [United States]: Lexi-Comp; American Pharmacists Association.
    1. La Revue Prescrire (n.d.). Rev Prescrire. Available: . Accessed Accessed: 2012 July 12.
    1. Bourrée F, Michel P, Salmi LR (2008) Methodes de consensus: Revue des méthodes originales et de leurs grandes variantes utilisées en santé publique. Rev Epidémiologie Santé Publique 56.
    1. Hsu CC, Sandford BA (2007) The Delphi technique: Making sense of consensus. Pract Assess Res Eval 12: 1–8.
    1. SurveyMonkey (n.d.) SurveyMonkey. SurveyMonkey. Available: . Accessed: 2012 Sept 12.
    1. ANSM (2013) Médicaments à base de tétrazépam, d’almitrine, de ranélate de strontium et de codéine (chez l’enfant) - Retour d’information sur le PRAC - ANSM. Médicam À Base Tétrazépam Almitrine Ranélate Strontium Codéine Chez Enfant - Retour Inf Sur Pr - ANSM. Available: . Accessed 2013 June 23.
    1. La Revue Prescrire (2014) Poux du cuir chevelu - Diméticone, substance pédiculicide de premier choix. Rev Prescrire 34: 198–202.
    1. Kaufmann CP, Tremp R, Hersberger KE, Lampert ML (2013) Inappropriate prescribing: a systematic overview of published assessment tools. Eur J Clin Pharmacol. Available: . Accessed 2013 Dec 16.
    1. Levy HB, Marcus EL, Christen C (2010) Beyond the beers criteria: A comparative overview of explicit criteria. Ann Pharmacother 44: 1968–1975.
    1. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, et al. (1991) Explicit Criteria for Determining Inappropriate Medication Use in Nursing Home Residents. Arch Intern Med 151: 18255–32.
    1. McLeod PJ, Huang AR, Tamblyn RM, Gayton DC (1997) Defining inappropriate practices in prescribing for elderly people: a national consensus panel. Can Med Assoc J 156: 385.
    1. Waller JL, Maclean JR (2003) Updating the Beers Criteria for potentially inappropriate medication use in older adults. Arch Intern Med 163: 2716–2724.
    1. Laroche M-L, Charmes J-P, Merle L (2007) Potentially inappropriate medications in the elderly: a French consensus panel list. Eur J Clin Pharmacol 63: 725–731 10.1007/s00228-007-0324-2
    1. Kaushal R, Bates DW, Landrigan C, McKenna KJ, Clapp MD, et al. (2001) Medication errors and adverse drug events in pediatric inpatients. JAMA J Am Med Assoc 285: 2114.
    1. Kaushal R, Goldmann DA, Keohane CA, Abramson EL, Woolf S, et al. (2010) Medication errors in paediatric outpatients. Qual Saf Health Care 19: 1–6 10.1136/qshc.2008.031179
    1. Davis T (2010) Paediatric prescribing errors. Arch Dis Child 96: 489–491 10.1136/adc.2010.200295
    1. Bates DW, Boyle DL, Vliet MBV, Schneider J, Leape L (1995) Relationship between medication errors and adverse drug events. J Gen Intern Med 10: 199–205.
    1. Schmitt E (1999) Le risque médicamenteux nosocomial: circuit hospitalier du médicament et qualité des soins. Masson. IX–287 p.

Source: PubMed

Sponsoren und Mitarbeiter

Krankheiten

Drogeninterventionen

3
Abonnieren