The incidence of drug-related problems as a cause of hospital admissions in children

Med J Aust. 1998 Oct 5;169(7):356-9.

Abstract

Objectives: To determine the incidence of hospital admissions for drug-related problems (DRPs) among children, and to examine cases for causality, preventability and clinical severity.

Design: Prospective assessment involving review of case notes and parent interview to determine if an admission was associated with a DRP.

Patients and setting: All patients admitted to a large university-affiliated paediatric hospital in Melbourne, Victoria, for medical reasons (i.e., not surgical, trauma or oncology patients) during 56 consecutive days from 24 June to 19 August 1996 for which a DRP could be identified. Patients whose parents or guardians could not communicate adequately in English were excluded.

Main outcome measures: The incidence, type, causality, preventability and clinical severity of DRPs associated with admission.

Results: Of 1682 eligible patients admitted to the Royal Children's Hospital during the study period, 58 admissions (3.4%) were associated with DRPs. Non-compliance was implicated in 50%. Causality was ranked as "definite" (34.5%), "possible" (56.9%) and "doubtful" (8.6). Two-thirds of admissions associated with DRPs were deemed preventable. Although no patients died from DRPs, four were admitted to the intensive care unit.

Conclusions: The incidence of DRPs as a cause of hospital admission in this study falls within the range of incidences published for the Australian adult population (range, 2.4%-22%). In contrast to findings among Australian adults, a high proportion of admissions for DRPs in this study were associated with non-compliance. The high percentage of preventable admissions indicates that further study is necessary to characterise risk factors within this population and to test prevention strategies.

MeSH terms

  • Adolescent
  • Adult
  • Causality
  • Child
  • Child, Preschool
  • Costs and Cost Analysis
  • Cross-Sectional Studies
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Hospitals, Pediatric / economics
  • Hospitals, Pediatric / statistics & numerical data
  • Humans
  • Incidence
  • Infant
  • Male
  • Patient Admission / economics
  • Patient Admission / statistics & numerical data*
  • Risk Factors
  • Victoria / epidemiology