Research Activities, January 2012: Child/Adolescent Health: A large proportion of hospitalized children receive numerous medications during their hospitalization
A large proportion of hospitalized children receive numerous medications during their hospitalizationA large proportion of hospitalized babies and children are given five or more drugs and therapeutic agents during each day they are in the hospital, reveals a new study. Children with less common conditions were more likely to be exposed to more drugs. A dozen drugs and therapeutic agents were taken over the course of the hospitalization for the typical child admitted to a children's hospital (median stay of 5 days) and two drugs and therapeutic agents for the typical child admitted to a general hospital (median stay of 2 days). However, these differences between hospital types were nullified when patient clinical characteristics were taken into account.
Children younger than 1 year at children's hospitals, who were at the 90th percentile of the number of the distinct drugs received, received 11 drugs on the first day of hospitalization, while children 1 year and older received 13 drugs; in general hospitals, the numbers were 8 and 12 drugs, respectively. By hospital day 7, those in children's hospitals who were younger than 1 year and at the 90th percentile of drug exposure had received 29 drugs and those 1 year or older had received 35 drugs; in general hospitals, the numbers were 22 and 28 drugs, respectively.
Cumulative numbers of distinct agents varied substantially among hospitals for three common conditions (asthma, appendectomy, and seizure), even after accounting for differences in length of stay for the condition. This suggests that actions can be taken to reduce the degree to which a child is exposed to multiple medications for common ailments while maintaining—or even improving—patient outcomes, note Chris Feudtner, M.D., Ph.D., M.P.H., of Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, and colleagues.
Their findings were based on 2006 data from the Pediatric Health Information System (40 children's hospitals) and the Perspective Data Warehouse (423 academic and community hospitals nationwide). The study was funded in part by the Agency for Healthcare Research and Quality (HS17991) to the University of Pennsylvania School of Medicine's Center for Education and Research on Therapeutics (CERT). For more information on the CERTs program, visit http://www.certs.hhs.gov/.
More details are in "Prevalence of polypharmacy exposure among hospitalized children in the United States" by Chris Feudtner, M.D., Ph.D., M.P.H., Dingwei Dai, Ph.D., Kari R. Hexem, M.P.H., and others in the September 2011 Archives of Pediatric and Adolescent Medicine (E-pub ahead of print).