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General medications utilization and cost patterns in hospitalized children Translated title: Utilización general de medicamentos y patrones de costes en niños hospitalizados

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      Abstract

      Drug utilization in the in-patient setting can provide mechanisms to assess drug prescribing trends, efficiency and cost-effectiveness of hospital formularies and examine sub-populations such as children for which prescribing habits are different from adults. Objectives: The aim of this descriptive study was to analyze general medication utilization patterns and costs excluding antimicrobials prescriptions and to compare two pediatric admission units in a tertiary care university hospital. Methods: The total number of admitted children was 1,521 and 1,467 for the A and B admission units, respectively. The electronic data from 252 and 253 hospitalized children in the A and B admission unit were prospectively screened for general medication prescriptions, children on antimicrobials were excluded from the analysis. Their electronic charts were viewed once weekly from October 15, 2007 up to April 7, 2008 using the prescription-point prevalence method. One medication was considered to be one prescription. Results: The general medications prescription number was 790 for 94 children (8.4 prescription/patient) in A and 959 for 88 children (10.9 prescription/patient) in B (p=0.02). The general medications defined daily dose (DDD) and drug utilization 90% (DU90%) index were 2,509.63, 2,259 for A; and 6,110.35, 5,499 for B, respectively. The DU90% index placed salbutamol inhalation with 835 DDD and sodium heparin with 2,102 DDD in the first place for the A and B admission units, respectively. A net increment in medication cost was registered according to the calculated cost from the depicted DU90% when the A (20,263 NIS) and B (6,269 NIS) admission units were compared (p=0.04). Conclusions: A significant difference in the prescription utilization of general medications was shown between the A and B admission units. The A admission unit had lower prescriptions measured by the DU90% index with higher medication cost. Potential drug-drug interactions were depicted in 18 (19%) and 17 (19%) subjects in the A and B admission unit, respectively.

      Translated abstract

      La utilización de medicamentos en el entorno hospitalario puede proporcionar mecanismos para evaluar las tendencias de prescripción de medicamentos, la eficiencia y coste-efectividad de los formularios hospitalarios y examinar sub-poblaciones tales como los niños para los que los hábitos de prescripción son diferentes de los adultos. Objetivos: El objetivo de este estudio descriptivo fue analizar los patrones y costes de la utilización de la medicación general excluyendo los antibióticos, y comparar dos unidades de ingreso pediátricas en un hospital universitario terciario. Métodos: El número total de niños admitidos fue de 1.521 y de 1.467 para las unidades de ingreso A y B, respectivamente. Se escrutaron los datos electrónicos de 252 y 253 niños hospitalizados en las unidades de ingreso A y B, a la búsqueda de la medicación general, excluyendo antibióticos. Sus historiales electrónicos se revisaban una vez a la semana desde el 15 de octubre de 2007 al 7 de abril de 2008 usando el método de prevalencia de prescripción. Se consideró que una medicación era una prescripción. Resultados: el número de medicaciones generales prescritas fue de 790 para 94 niños (8,4 prescripciones/paciente) en A y 959 para 88 niños (10,9 prescripciones/paciente) en B (p=0,02). Las dosis diarias definidas (DDD) y utilización de medicamento90% (DU90%) para la medicación general fueron 2.509.63 y 2.259 para A; and 6.110,35 y 5.499 para B, respectivamente. El índice DU90% situó las inhalaciones con salbutamol con 835 DDD y la heparina sódica con 2.102 DDD en el primer lugar para las unidades A y B de ingreso, respectivamente. Se registró un incremento neto del coste de medicación de acuerdo con el coste calculado de lo dibujado por el DU90% cuando se comparaban las unidades A (20.263 NIS) y B (6.269 NIS) (p=0,04). Conclusiones: Se vio una diferencia significativa en la utilización de prescripciones de medicación general entre las unidades de ingreso A y B. La unidad A tenía menores prescripciones medidas con el índice DU90% de mayor coste. Se identificaron 18 (19%) y 17 (19%) interacciones medicamentosas potenciales en los individuos de las unidades A y B, respectivamente.

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      Most cited references 15

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      Adverse drug reactions in neonates.

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      Adverse drug reactions (ADR) are uncommon causes of admission of neonates to the neonatal intensive care unit. The neonate, however, is potentially at significant risk for adverse drug reactions because of underdeveloped mechanisms and systems for handling drugs (the Gray Baby Syndrome with chloramphenicol as a classic example), the fact that infants in neonatal intensive care units are often critically ill with multiple organ system dysfunction, that they may be on multiple drugs, and that they may present with an adverse drug reaction as a result of exposure while still a fetus. There is also a history of misadventures in the neonatal intensive care unit and newborn nurseries due to exposure to antibacterial agents that produced systemic effects from percutaneous absorption. In this review, an overview of the mechanisms of adverse drug reactions will be presented, followed by a general review of the experience of adverse drug reactions in neonates and some specific examples of current adverse drug reactions and a suggested approach for the prevention and evaluation of adverse drug reactions in neonates.
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            Author and article information

            Affiliations
            [1 ] Technion Israel Institute of Technology Israel
            [2 ] Technion Israel Institute of Technology Israel
            [3 ] Rambam Health Care Campus Israel
            Contributors
            Role: ND
            Role: ND
            Role: ND
            Role: ND
            Journal
            pharmacy
            Pharmacy Practice (Granada)
            Pharmacy Pract (Granada)
            Centro de Investigaciones y Publicaciones Farmacéuticas
            1885-642X
            March 2009
            : 7
            : 1
            : 54-58
            S1885-642X2009000100008

            This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

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            Product Information: SciELO Spain

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