PLoS ONE (Jan 2019)

Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research.

  • Béatrice Gouyon,
  • Séverine Martin-Mons,
  • Silvia Iacobelli,
  • Hasinirina Razafimahefa,
  • Elsa Kermorvant-Duchemin,
  • Roselyne Brat,
  • Laurence Caeymaex,
  • Yvan Couringa,
  • Ceneric Alexandre,
  • Catherine Lafon,
  • Duksha Ramful,
  • Francesco Bonsante,
  • Guillaume Binson,
  • Florence Flamein,
  • Amélie Moussy-Durandy,
  • Massimo Di Maio,
  • Gaël Mazeiras,
  • Olivier Girard,
  • Cécile Desbruyeres,
  • Julien Mourdie,
  • Guillaume Escourrou,
  • Olivier Flechelles,
  • Soumeth Abasse,
  • Jean-Marc Rosenthal,
  • Anne-Sophie Pages,
  • Marine Dorsi,
  • Léila Karaoui,
  • Abdellah ElGellab,
  • Florence Le Bail Dantec,
  • Mohamed-Amine Yangui,
  • Karine Norbert,
  • Yaovi Kugbe,
  • Simon Lorrain,
  • Anaelle Pignolet,
  • Elodie Marie Garnier,
  • Alexandre Lapillonne,
  • Delphine Mitanchez,
  • Evelyne Jacqz-Aigrain,
  • Jean-Bernard Gouyon

DOI
https://doi.org/10.1371/journal.pone.0222667
Journal volume & issue
Vol. 14, no. 9
p. e0222667

Abstract

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ObjectivesThe primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW.Material and methodsThe research is a two-year observational cohort study (2017-2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse.ResultsThe study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (pConclusionNeonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.