Incidence of Medication-Related Problems Following Pediatric Epilepsy Admissions

• Published in: Pediatric neurology Vol. 142; pp. 10 - 15
• Main Authors: Kulawiak, Jessica, Miller, Joette Amundaray, Hovey, Sara W.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-05-2023
• Subjects: Child; Epilepsy; Epilepsy - drug therapy; Epilepsy - epidemiology; Hospitalization; Humans; Incidence; Medication education; Medication errors; Medication-related problems; Patient discharge; Pharmacist; Pharmacists; Retrospective Studies; Transitions of care; Medication-related problems; Transitions of care; Epilepsy; Patient discharge; Pharmacist; Medication education; Medication errors
• ISSN: 0887-8994; 1873-5150
• DOI: 10.1016/j.pediatrneurol.2023.01.015

An estimated 26% to 33% of pediatric patients have at least one medication error at hospital discharge. Pediatric patients with epilepsy may be at greater risk due to complex medication regimens and frequent hospitalizations. This study aims to quantify the proportion of pediatric patients with epilepsy experiencing medication problems after discharge and determine if medication education decreases these problems.
This was a retrospective cohort study including pediatric patients with epilepsy-related hospital admissions. Cohort 1 consisted of a control group, and cohort 2 consisted of patients who received discharge medication education, enrolled in a 2:1 ratio. The medical record was reviewed from hospital discharge to outpatient neurology follow-up to identify medication problems that occurred. The primary outcome was the difference in proportion of medication problems between the cohorts. Secondary outcomes were incidence of medication problems with harm potential, overall incidence of medication problems, and 30-day epilepsy-related readmissions.
A total of 221 patients were included (163 in the control cohort and 58 in the discharge education cohort) with balanced demographics. The incidence of medication problems was 29.4% in the control cohort and 24.1% in the discharge education cohort (P = 0.44). The most common problems were mismatched dose or direction. Medication problems with harm potential were 54.2% in the control group and 28.6% in the discharge education cohort (P = 0.131).
Medication problems and their harm potential were lower in the discharge education cohort, but the difference was not significant. This demonstrates education alone may not be enough to impact medication error rates.