Systematic review of the prevalence and nature of drug-related problems in paediatric patients

Abstract

What is known and objective: A drug-related problem (DRP) is “an event or circumstance involving drug therapy that actually or potentially interferes with the desired health outcome.” The paediatric population is easily affected by DRPs. The aim of this study was to evaluate different types and characteristics of DRPs in paediatric patients. This finding can be used as a baseline in epidemiology for assessing potential risk factors for DRPs in paediatric patients. Methods: An extensive search strategy was designed to retrieve all articles published from the date of inception of the database to 1 May 2020, by combining the terms “drug-related problem” and “paediatric” in several electronic databases (PubMed, Cochrane Library, Embase and Web of Science) and following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Observational and interventional studies report that the epidemiology of DRPs in paediatric patients was included. Two reviewers independently screened studies, extracted data, assessed the quality of the included studies and then qualitatively analysed the results. Results: Eighteen studies were included in the final analysis, and 6 different classification systems on paediatric-related DRPs were reported. Overall, these studies showed that paediatric patients are easily affected by DRPs. However, the majority of DRPs are considered preventable, and the severity of DRPs in paediatric patients is mostly considered minor and moderate. Dosing-related problems rank highest in terms of frequency, and the number of prescribed drugs has a positive correlation with the occurrence of DRPs. What is new and conclusion: This study showed that paediatric patients are easily affected by DRPs, but the majority of DRPs are preventable, which indicate that actions should be taken. To reduce DRPs in paediatric patients of the interventions that are noticed, clinical pharmacy services show promising improvement on reducing DRPs compared with other interventions.