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Manipulations of Oral Medications in Paediatric Neurology and Oncology Care at a Swedish University Hospital: Health Professionals' Attitudes and Sources of Information
University of Skövde, School of Health Sciences. University of Skövde, Digital Health Research (DHEAR). Department of Women’s and Children’s Health, Uppsala University, Sweden ; Division of Pharmacokinetics and Drug Therapy, Department of Pharmaceutical Biosciences, Uppsala University, Sweden. (Translationell medicin (TRIM))ORCID iD: 0000-0002-1665-4645
Department of Women’s and Children’s Health, Uppsala University, Sweden.
Department of Women’s and Children’s Health, Uppsala University, Sweden.
Department of Women’s and Children’s Health, Uppsala University, Sweden.
2021 (English)In: Pharmaceutics, ISSN 1999-4923, E-ISSN 1999-4923, Vol. 13, no 10, article id 1676Article in journal (Refereed) Published
Abstract [en]

Oral administration of medications to children requires age-appropriate dosage forms and strengths. In this study, we: (i) assessed the extent of oral dosage form manipulations, (ii) documented how it is carried out, and (iii) examined the attitudes and sources of information regarding the handling from healthcare professionals. Prospective reviews of electronic records, ward observations, and clinician surveys were performed at a paediatric neurology ward and a paediatric oncology ward in Sweden during April to May of 2018. Approximately 15% of oral medications were manipulated for the studied patient group (median age 12.9 years in oncology, 5.8 years in neurology) with approximately 30% of the patients having an enteral feeding tube. Manipulations were performed both to obtain an appropriate dose from, for example, a fraction of the original tablet or to obtain a powder that could be used to prepare a slurry for administration through enteral feeding tubes. Risks identified were related to patient safety such as cross contamination, suboptimal absorption/pharmacokinetics and inaccurate dose. When examining the working environment of nurses, we observed safe handling of hazardous substances but the nurses occasionally experienced stress and a fear of making mistakes due to absence of information. Paediatricians experienced a lack of time to search for proper information on manipulations. As a step towards improving safety in paediatric medication, we suggest the introduction of clinical pharmacists into the team and further evaluating the possibilities of using more ready-to-administer medications with necessary product information and pharmacovigilance support.

Place, publisher, year, edition, pages
MDPI, 2021. Vol. 13, no 10, article id 1676
Keywords [en]
paediatrics, children, manipulation, oral medication, patient safety, survey, health care professionals' attitude, enteral feeding tubes, pharmacoprinting
National Category
Pharmaceutical Sciences
Research subject
Translational Medicine TRIM
Identifiers
URN: urn:nbn:se:his:diva-20708DOI: 10.3390/pharmaceutics13101676ISI: 000715423400001PubMedID: 34683968Scopus ID: 2-s2.0-85117918116OAI: oai:DiVA.org:his-20708DiVA, id: diva2:1612407
Funder
Familjen Erling-Perssons Stiftelse, 2017
Note

CC BY 4.0

Correspondence: mattias.paulsson@kbh.uu.se; Tel.: +46-18-611-3733

Funding by the Erling-Persson Family Foundation (2017) is gratefully acknowledged.

Available from: 2021-11-18 Created: 2021-11-18 Last updated: 2022-04-11Bibliographically approved

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Kader, Rania

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