The tool was named Pediatrics: Omission of Prescriptions and Inappropriate prescriptionsВ (POPI) ( table 1). 34 35 In order to improve the correct drug use and optimise practice, the first tool of detection for PIM and PPO was created by Prot-Labarthe et al in 2013. 35В Optimising childrenвЂ™s care is based on rational prescribing and aims for a decrease in side effects. 6 34 Questions about the rationale of prescriptions could be asked. 4 33 Large differences relating to treatment were seen within and between countries. This frequency is explained by the vulnerability of children, pharmacokinetic changes during childhood and paediatric off-label drug used. 32 ADRs are three time higher in paediatric populations. With many off-label uses, they may be obligated to find alternative information sources and might even dispense infrequently for this vulnerable population. 31 This is a worry in a hospital or general practitioner setting and for the community pharmacists. It is often empirical and primarily based on safety and pharmacology information obtained in adults. Prescribing in a paediatric population is always challenging for physicians. 27 28 Negative outcomes related to an IP such as side effects, hospitalisation, mortality and utilisation of resources were also highlighted. Omission of prescriptions in geriatric population detected by the START tool concerned 58%вЂ“61% of patients. 15 Using these tools, many studies have been carried out which have detected that IPs range from 35% to 51% in the above population. Only the STOPP/START enables us to detect underprescription. In an elderly population, which presents with age-related physiological changes and high prevalence of polypharmacy, various measures have been developed to detect PIM such as: BeersвЂ™ criteria, the Inappropriate Prescribing in the Elderly Tool, The Medication Appropriate Index and Screening Tool of Older PersonвЂ™s prescriptions/Screening Tool to Alert doctor to Right TreatmentВ (STOPP/START).

PPO or underuse of appropriate medication is defined as the absence of initiation of an effective treatment in subjects with a condition for which one or several drug classes have demonstrated their efficacy. 15 In a report from the French National Authority for Health, PIMs are defined as вЂdrugs being used in a situation in which the risks involved in treatment potentially outweigh the benefits, lack of demonstrated indication, high risk of ADE, or an unfavorable cost-effect or risk-benefit ratio existsвЂ™.

14 The most recent definition of inappropriate prescription (IP) encompasses potentially inappropriate medicines (PIMs) andВ potentially prescribing omissions (PPOs). The WHO estimated that 50% of medications are prescribed and used inappropriately. 6 7 10 Many drugs were concerned in commonly used medication.

6вЂ“9 Incidence of ADR leading to admission was evaluated between 1.8% and 17.7%. 3вЂ“5 In the paediatric population, ADR during hospitalisation was estimated between 0.6% and 33.7% and between 1% and 1.5% for outpatients. 1 2 In the literature, ADE is defined by вЂan injury resulting from medical intervention related to a drugвЂ™ (dose error, adverse drug reaction (ADR)В and misuse of medication such as antibiotics). Inappropriate prescribing is a known preventable cause of adverse drug events (ADEs) and has an important impact on public health and cost of care. Many omissions and inappropriate prescriptions can be easily detected with POPI despite limited clinical information.

The lack of clinical information is the main limit to detection in a community setting. Some criteria could only be analysed in a prospective study. The prevalence of PIM and PPO may be underestimated (large number of prescriptionsВ and absence of specific pathology). It is a retrospective and monocentric study. This study is the first to observe the prevalence of potentially inappropriate medicine (PIM) and potentially prescribing omission (PPO) in a paediatric population.

Diane 35 acnГ© rГ©sultats