General medications utilization and cost patterns in hospitalized children

Doaa Okasha; Imad Kassis; Salim Haddad; Norberto Krivoy

doi:10.4321/s1886-36552009000100008

General medications utilization and cost patterns in hospitalized children

Pharm Pract (Granada). 2009 Jan;7(1):54-8. doi: 10.4321/s1886-36552009000100008. Epub 2009 Mar 15.

Authors

Doaa Okasha¹, Imad Kassis², Salim Haddad³, Norberto Krivoy⁴

Affiliations

¹ Clinical Pharmacology Institute, Rambam Health Care Campus. Haifa ( Israel ).
² Senior Physician in Pediatric and Infectious Diseases, Pediatric Infectious Diseases Unit, Meyer Pediatric Hospital, Rambam Health Care Campus. B. Rappaport Faculty of Medicine, Technion -Israel Institute of Technology, Haifa ( Israel ).
³ Chief Pharmacist and Director of the Central Pharmacy, Pharmacy Services, Rambam Health Care Campus. Haifa ( Israel ).
⁴ Senior Physician in Medicine and Director of the Clinical Pharmacology Institute, Rambam Health Care Campus. B. Rappaport Faculty of Medicine, Technion -Israel Institute of Technology, Haifa ( Israel ).

Abstract

Drug utilization in the in-patient setting can provide mechanisms to assess drug prescribing trends, efficiency and cost-effectiveness of hospital formularies and examine sub-populations such as children for which prescribing habits are different from adults.

Objectives: The aim of this descriptive study was to analyze general medication utilization patterns and costs excluding antimicrobials prescriptions and to compare two pediatric admission units in a tertiary care university hospital.

Methods: The total number of admitted children was 1,521 and 1,467 for the A and B admission units, respectively. The electronic data from 252 and 253 hospitalized children in the A and B admission unit were prospectively screened for general medication prescriptions, children on antimicrobials were excluded from the analysis. Their electronic charts were viewed once weekly from October 15, 2007 up to April 7, 2008 using the prescription-point prevalence method. One medication was considered to be one prescription.

Results: The general medications prescription number was 790 for 94 children (8.4 prescription/patient) in A and 959 for 88 children (10.9 prescription/patient) in B (p=0.02). The general medications defined daily dose (DDD) and drug utilization 90% (DU90%) index were 2,509.63, 2,259 for A; and 6,110.35, 5,499 for B, respectively. The DU90% index placed salbutamol inhalation with 835 DDD and sodium heparin with 2,102 DDD in the first place for the A and B admission units, respectively. A net increment in medication cost was registered according to the calculated cost from the depicted DU90% when the A (20,263 NIS) and B (6,269 NIS) admission units were compared (p=0.04).

Conclusions: A significant difference in the prescription utilization of general medications was shown between the A and B admission units. The A admission unit had lower prescriptions measured by the DU90% index with higher medication cost. Potential drug-drug interactions were depicted in 18 (19%) and 17 (19%) subjects in the A and B admission unit, respectively.

Keywords: Child; Drug Utilization; Inpatients; Israel.