Journal of Experimental & Clinical Medicine
Volume 2, Issue 4 , Pages 173-180, August 2010

Outcomes of Pharmacy Interventions on Pediatric Medication Prescribing Patterns in Taiwan

  • You-Meei Lin

      Affiliations

    • Department of Pharmacy, Taipei Medical University–Shuang Ho Hospital, Taipei, Taiwan
  • ,
  • Yi-Chun Chiang

      Affiliations

    • Department of Pharmacy, Taipei Medical University–Wan Fang Hospital, Taipei, Taiwan
    • School of Pharmacy, Taipei Medical University, Taipei, Taiwan
  • ,
  • Yung-Ting Kuo

      Affiliations

    • Department of Pediatrics, Taipei Medical University–Shuang Ho Hospital, Taipei, Taiwan
  • ,
  • Man-Yau Ho

      Affiliations

    • Department of Pediatrics, Taipei Medical University–Wan Fang Hospital, Taipei, Taiwan
  • ,
  • Hsiang-Yin Chen

      Affiliations

    • Department of Pharmacy, Taipei Medical University–Wan Fang Hospital, Taipei, Taiwan
    • School of Pharmacy, Taipei Medical University, Taipei, Taiwan
    • Corresponding Author InformationCorresponding author. Department of Pharmacy, Taipei Medical University–Wan Fang Hospital, 111, Section 3, Hsing-Long Road, Taipei 116, Taiwan

Received 16 November 2009; received in revised form 19 March 2010; accepted 28 April 2010.

Article Outline

Background/Purpose

The aim of this study was to assess the long-term effect of pharmacy interventions on patients and health care providers, and switching from prescribing extemporaneous powder dosage forms to liquid dosage forms.

Methods

An education program for parents was conducted. An attitude, knowledge and behavior questionnaire was employed to measure the efficacy of the education program. Medication management policies were then executed by providing an in-service to pediatricians, establishing dosage-switching guidelines and adding liquid dosage forms of necessary medications into the hospital formulary. Dosage-switching guidelines of pediatric medications were established by surveying the most prescribed extemporaneous powder dosage forms at the Taipei Medical University–Wan Fang Hospital. These guidelines were introduced to every pediatrician, nurse and pharmacist. The prescribing rate of extemporaneous powder prescriptions was monitored to measure the outcomes of the interventions.

Results

The mean scores of attitude, knowledge and practice significantly improved towards a positive use of commercially available liquid medications after the patient education program for the parents. Prescriptions for extemporaneous powder dosage forms significantly decreased from 1600 (2.54%) to 13 (0.022%) monthly in the 4th year and were reduced to zero in the 6th year.

Conclusion

This study demonstrated that the pharmacists' interventions were able to change the parents' knowledge, attitude and practice towards pediatric drug dosage forms and the prescribing pattern. Effective assurance in children's medication safety can be achieved through collaboration between medical professionals and parents.

Key Words:  dosage switching guidelines , intervention , medication safety , pediatrics

No full text is available. To read the body of this article, please view the PDF online.

 

Back to Article Outline

References 

  1. Wilson JT . An update on the therapeutic orphan . Pediatrics . 1999;104:585–590
  2. Nahata MC . Lack of pediatric drug formulations . Pediatrics . 1999;104:607–609
  3. Meadows M . Drug research and children . FDA Consum . 2003;37:12–17
  4. Glass BD , Haywood A . Stability considerations in liquid dosage forms extemporaneously prepared from commercially available products . J Pharm Pharm Sci . 2006;9:398–426
  5. Taiwan Health Reform Foundation. Safety in Pediatric Drug Therapy-The Reasons for THRF to Advocate It. Taipei: Taiwan Health Reform Foundation, 2006. Available at http://www.thrf.org.tw/Uploads/{976B276E-FFA4-4F2A-A53F-D9C011214947}_961118 -.pdf [In Chinese] [Date accessed: December 18, 2007]
  6. Taiwan Health Reform Foundation  . Breaking the Eight Myths of Pediatric Extemporaneous Powder Drugs . Taipei: Taiwan Health Reform Foundation; 2007; Available at http://www.thrf.org.tw/Uploads/%7B976B276E-FFA4-4F2A-A53F-D9C011214947%7D_961118%E6%96%B0%E8%81%9E%E7%A8%BF%E4%B8%80%E9%99%84%E4%BB%B6.pdf [In Chinese] [Date accessed: December 18, 2007]
  7. Perrin JH . Pediatrician and compounding pharmacist: a dangerous liaison . Arch Pediatr Adolesc Med . 1996;150:224–226
  8. Lin TR , Kao Yang YH , Huang YF , Tsai JC . Content uniformity of captopril, furosemide, nadolol and propranolol hydrochloride powder packets extemporaneously compounded from tablets . Chin Pharm J . 2000;52:59–68
  9. Jacob V , Aranda SJY . Neonatal and Pediatric Pharmacology: Therapeutic Principles in Practice . 3rd ed.. Philadelphia: Lippincott Williams and Wilkins; 2005;
  10. Bauer LA . Clinical pharmacokinetics and pharmacodynamics . In:  DiPiro JT ,  Talbert RL ,  Wells BG ,  Yee GC ,  Matzke G ,  Posey LM editor. Pharmacotherapy: A Pathophysiologic Approach . 6th ed.. New York: McGraw-Hill Publishing; 2005;p. 33–54
  11. In:  Helms RA ,  Quan DJ editor. Textbook of Therapeutics: Drug and Disease Management . 8th ed.. Philadelphia: Lippincott Williams and Wilkins; 2006;
  12. Schapansky LM , Johnson JA . Pharmacists' attitudes toward diabetes . J Am Pharm Assoc (Wash) . 2000;40:371–377
  13. Sharp LK , Lipsky MS . The short-term impact of a continuing medical education program on providers' attitudes toward treating diabetes . Diabetes Care . 1999;22:1929–1932
  14. Fortescue EB, Kaushal R, Landrigan CP, McKenna KJ, Clapp MD, Federico F, et al  Prioritizing strategies for preventing medication errors and adverse drug events in pediatric inpatients . Pediatrics . 2003;111:722–729
  15. Juang SY . Study on Quality Assurance of Compounding Process for Pediatric Divided Powders . Taipei: School of Pharmacy, National Taiwan University; 2001;
  16. Lin FL , Gau CS , Chen RR . Pharmaceutical perspective of drug therapy in pediatrics . Formos J Med . 2000;4:200–214

PII: S1878-3317(10)60027-7

doi:10.1016/S1878-3317(10)60027-7

Journal of Experimental & Clinical Medicine
Volume 2, Issue 4 , Pages 173-180, August 2010