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Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam

Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-se...

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Autores principales: Nguyen, Thao H., Le, Vy T. T., Quach, Dung N., Diep, Han G., Nguyen, Nguyet K., Lam, Anh N., Pham, Suol T., Taxis, Katja, Nguyen, Thang, Nguyen, Phuong M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002152/
https://www.ncbi.nlm.nih.gov/pubmed/33799438
http://dx.doi.org/10.3390/healthcare9030327
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author Nguyen, Thao H.
Le, Vy T. T.
Quach, Dung N.
Diep, Han G.
Nguyen, Nguyet K.
Lam, Anh N.
Pham, Suol T.
Taxis, Katja
Nguyen, Thang
Nguyen, Phuong M.
author_facet Nguyen, Thao H.
Le, Vy T. T.
Quach, Dung N.
Diep, Han G.
Nguyen, Nguyet K.
Lam, Anh N.
Pham, Suol T.
Taxis, Katja
Nguyen, Thang
Nguyen, Phuong M.
author_sort Nguyen, Thao H.
collection PubMed
description Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. Results: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss’ coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599–0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672–0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607–0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219–1.655). Patients prescribed ≥5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907–4.650). Conclusion: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs.
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spelling pubmed-80021522021-03-28 Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam Nguyen, Thao H. Le, Vy T. T. Quach, Dung N. Diep, Han G. Nguyen, Nguyet K. Lam, Anh N. Pham, Suol T. Taxis, Katja Nguyen, Thang Nguyen, Phuong M. Healthcare (Basel) Article Background: Our study was conducted to determine the prevalence of drug-related problems (DRPs) in outpatient prescriptions, the impact of DRPs on treatment efficacy, safety, and cost, and the determinants of DRPs in prescribing for pediatric outpatients in Vietnam. Methods: A retrospective cross-sectional study was conducted on pediatric outpatients at a pediatric hospital in Can Tho, Vietnam. DRPs were classified according to the Pharmaceutical Care Network Europe classification (PCNE) of 2020. The study determined prevalence of DRPs and their impacts on efficacy, safety, and cost. Multivariate regression was used to identify the determinants of DRPs. Results: The study included 4339 patients (mean age 4.3, 55.8% male), with a total of 3994 DRPs, averaging 0.92 DRP/prescription. The proportion of prescriptions with at least one DRP was 65.7%. DRPs included inappropriate drug selection (35.6%), wrong time of dosing relative to meals (35.6%), inappropriate dosage form (9.3%), inappropriate indication (7.1%), and drug-drug interactions (0.3%). The consensus of experts was average when evaluating each aspect of efficiency reduction, safety reduction, and treatment cost increase, with Fleiss’ coefficients of 0.558, 0.511, and 0.541, respectively (p < 0.001). Regarding prescriptions, 50.1% were assessed as reducing safety. The figures for increased costs and decreased treatment effectiveness were 29.0% and 23.9%, respectively. Patients who were ≤2 years old were more likely to have DRPs than patients aged 2 to 6 years old (OR = 0.696; 95% CI = 0.599–0.809) and patients aged over 6 years old (OR = 0.801; 95% CI = 0.672–0.955). Patients who had respiratory system disease were more likely to have DRPs than patients suffering from other diseases (OR = 0.715; 95% CI = 0.607–0.843). Patients with comorbidities were less likely to have DRPs than patients with no comorbidities (OR = 1.421; 95% CI = 1.219–1.655). Patients prescribed ≥5 drugs were more likely to have DRPs than patients who took fewer drugs (OR = 3.677; 95% CI = 2.907–4.650). Conclusion: The proportion of prescriptions in at least one DRP was quite high. Further studies should evaluate clinical significance and appropriate interventions, such as providing drug information and consulting doctors about DRPs. MDPI 2021-03-14 /pmc/articles/PMC8002152/ /pubmed/33799438 http://dx.doi.org/10.3390/healthcare9030327 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Article
Nguyen, Thao H.
Le, Vy T. T.
Quach, Dung N.
Diep, Han G.
Nguyen, Nguyet K.
Lam, Anh N.
Pham, Suol T.
Taxis, Katja
Nguyen, Thang
Nguyen, Phuong M.
Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title_full Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title_fullStr Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title_full_unstemmed Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title_short Drug-Related Problems in Prescribing for Pediatric Outpatients in Vietnam
title_sort drug-related problems in prescribing for pediatric outpatients in vietnam
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8002152/
https://www.ncbi.nlm.nih.gov/pubmed/33799438
http://dx.doi.org/10.3390/healthcare9030327
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