Integrated Pharmacy Research and Practice (Aug 2021)

Expert Consensus on a List of Inappropriate Prescribing after Prescription Review in Pediatric Units in Abidjan, Côte d’Ivoire

  • Doffou E,
  • Avi C,
  • Yao KC,
  • Abrogoua DP

Journal volume & issue
Vol. Volume 10
pp. 79 – 91

Abstract

Read online

Elisée Doffou,1,2 Christelle Avi,3 Kouassi Christian Yao,3 Danho Pascal Abrogoua1,4 1Therapeutic and Clinical Pharmacy Laboratory, Faculty of Pharmaceutical and Biological Sciences, Félix Houphouët-Boigny University, Abidjan, Côte d’Ivoire; 2Department of Pharmacy, Teaching Hospital of Cocody, Abidjan, Côte d’Ivoire; 3Department of Pediatrics, Teaching Hospital of Bouaké, Bouaké, Côte d’Ivoire; 4Department of Clinical Pharmacology, Teaching Hospital of Cocody, Abidjan, Côte d’IvoireCorrespondence: Elisée Doffou Email [email protected]: Inappropriate prescribing (IP) includes inappropriate prescription and omission of prescription. IP can adversely affect the quality of health care in pediatric units. A list of IP taking into account frequently encountered drug-related problems (DRPs) can be useful to optimize prescriptions in pediatrics. The aim of this study was to validate by expert consensus a list of IP after a prescription review in pediatric units in Abidjan.Materials and Methods: A list of IPs was developed from a prescription review of inpatients and outpatients aged 1 month to 15 years and followed in pediatric units at teaching hospitals of Abidjan during 16 months. A two-round Delphi method was used to validate a qualitative list of IPs by experts according to their level of agreement on a six-point Likert scale of 0– 5 (0, no opinion; 5, strongly agree). Only propositions obtaining the agreement (rating 4 or 5) of > 70% of experts who gave a non-zero rating for the first round and 80% for the second round were retained.Results: A qualitative list of 54 IPs was drawn up from 267 DRPs detected after prescription review of 4,992 prescription lines for 881 patients. Our panel comprised 22 pediatricians (96%) and one clinical pharmacist (4%). Mean agreement ratings were 4.43/5 (95% CI 4.39– 4.48) and 4.6/5 (95% CI 4.56– 4.64), respectively, during the first Delphi round and the second (p< 0.001). At the end of the first round, all items submitted (54) were retained, including 13 items that had been reworded. In the second round, 20 experts participated and two IPs (4%) were not retained for the final list. This list comprised 52 IPs (44 inappropriate prescriptions and eight omissions of prescription).Conclusion: The list of IP validated in this study should help in the detection of DRPs and optimize prescriptions in pediatric units in Côte d’Ivoire.Keywords: inappropriate prescribing, consensus, experts, pediatrics, Côte d’Ivoire

Keywords