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Retrospective study of irrational prescribing in French paediatric hospital: prevalence of inappropriate prescription detected by Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) in the emergency unit and in the ambulatory setting
  1. Aurore Berthe-Aucejo1,2,
  2. Phuong Khanh Hoang Nguyen1,
  3. François Angoulvant2,3,
  4. Xavier Bellettre4,
  5. Patrick Albaret5,6,
  6. Thomas Weil1,
  7. Rym Boulkedid2,7,8,
  8. Olivier Bourdon1,6,9,10,
  9. Sonia Prot-Labarthe1,2,10
  1. 1Department of Pharmacy, AP-HP, Robert-Debré Hospital, Paris, France
  2. 2UMR-S1123, ECEVE; Inserm U1123, INSERM, Paris, Île-de-France, France
  3. 3Emergency Unit, AP-HP, Necker Hospital, Paris, Île-de-France, France
  4. 4Emergency unit, AP-HP, Robert-Debré Hospital, Paris, Île-de-France, France
  5. 5Pharmacy, Albaret Pharmacy, Cesson, France
  6. 6Clinical Pharmacy, Paris Descartes University, Paris, Île-de-France, France
  7. 7Clinical Epidemiology Unit, Robert-Debré Hospital, Paris, Île-de-France, France
  8. 8CIC-EC 1426, AP-HP, Robert-Debré Hospital, Paris, Île-de-France, France
  9. 9Laboratoire Educations et Pratiques de Santé, Paris XIII University, Bobigny, France
  10. 10Groupe Pédiatrie, Société Française de Pharmacie Clinique, Paris, France
  1. Correspondence to Dr Aurore Berthe-Aucejo; aurore.berthe84{at}gmail.com

Abstract

Background and objective Pediatrics: Omission of Prescription and Inappropriate prescription (POPI) is the first detection tool for potentially inappropriate medicines (PIMs) and potentially prescribing omissions (PPOs) in paediatrics. The aim of this study was to evaluate the prevalence of PIM and PPO detected by POPI regarding prescriptions in hospital and for outpatients. The second objective is to determine the risk factors related to PIM and PPO.

Design A retrospective, descriptive study was conducted in the emergency department (ED) and community pharmacy (CP) during 6 months. POPI was used to identify PIM and PPO.

Setting Robert-Debré Hospital (France) and Albaret community pharmacy (Seine and Marne).

Participants Patients who were under 18 years old and who had one or more drugs prescribed were included. Exclusion criteria consisted of inaccessible medical records for patients consulted in ED and prescription without drugs for outpatients.

Primary and secondary outcome measures PIM and PPO rate and risk factors.

Results At the ED, 18 562 prescriptions of 15 973 patients and 4780 prescriptions of 2225 patients at the CP were analysed. The PIM rate and PPO rate were, respectively, 2.9% and 2.3% at the ED and 12.3% and 6.1% at the CP. Respiratory and digestive diseases had the highest rate of PIM.

Conclusion This is the first study to assess the prevalence of PIM and PPO detected by POPI in a paediatric population. This study assessed PIMs or PPOs within a hospital and a community pharmacy. POPI could be used to improve drug use and patient care and to limit hospitalisation and adverse drug reaction. A prospective multicentric study should be conducted to evaluate the impact and benefit of implementing POPI in clinical practice.

  • inappropriate prescription
  • omission
  • tool
  • detection

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

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Footnotes

  • Contributors SP-L and AB-A conceptualised and designed the study, drafted the initial manuscript and approved the final manuscript as submitted. RB and PKHN carried out analyses, reviewed and revised the manuscript and approved the final manuscript as submitted. XB, TW and OB reviewed and revised the manuscript and approved the final manuscript as submitted. FA and PA supplied data from hospital and community pharmacy and reviewed and revised the manuscript and approved the final manuscript as submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This project was approved by the local research ethics committee (n°2015/218).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement We have no additional unpublished data.