Open AccessCharacteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research
Author(s) -
Béatrice Gouyon,
Séverine Martin-Mons,
Simona Iacobelli,
Hasinirina Razafimahefa,
Elsa KermorvantDuchemin,
Roselyne Brat,
Laurence Caeymaex,
Yvan Couringa,
Cénéric Alexandre,
Catherine Lafon,
Duksha Ramful,
Francesco Bonsante,
Guillaume Binson,
Florence Flamein,
Amélie Moussy-Durandy,
Massimo Di Maïo,
Gaël Mazeiras,
Olivier Girard,
Cécile Desbruyeres,
Julien Mourdie,
Guillaume Escourrou,
Olivier Fléchelles,
Soumeth Abasse,
Jean-Marc Rosenthal,
Anne-Sophie Pages,
M. D’Orsi,
Leïla Karaoui,
Abdellah ElGellab,
Florence Le Bail Dantec,
Mohamed-Amine Yangui,
Karine Norbert,
Yaovi Kugbe,
Simon Lorrain,
Anaelle Pignolet,
Élodie Garnier,
Alexandre Lapillonne,
Delphine Mitanchez,
Evelyne JacqzAigrain,
JeanBernard Gouyon
Publication year - 2019
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0222667
Subject(s) - medical prescription , medicine , observational study , pediatrics , retrospective cohort study , population , cohort study , gestational age , pregnancy , environmental health , biology , pharmacology , genetics
Objectives The primary objective of this study is to determine the current level of patient medication exposure in Level 3 Neonatal Wards (L3NW). The secondary objective is to evaluate in the first month of life the rate of medication prescription not cited in the Summary of Product Characteristics (SmPC). A database containing all the medication prescriptions is collected as part of a prescription benchmarking program in the L3NW. Material and methods The research is a two-year observational cohort study (2017–2018) with retrospective analysis of medications prescribed in 29 French L3NW. Seventeen L3NW are present since the beginning of the study and 12 have been progressively included. All neonatal units used the same computerized system of prescription, and all prescription data were completely de-identified within each hospital before being stored in a common data warehouse. Results The study population includes 27,382 newborns. Two hundred and sixty-one different medications (International Nonproprietary Names, INN) were prescribed. Twelve INN (including paracetamol) were prescribed for at least 10% of patients, 55 for less than 10% but at least 1% and 194 to less than 1%. The lowest gestational ages (GA) were exposed to the greatest number of medications (18.0 below 28 weeks of gestation (WG) to 4.1 above 36 WG) (p<0.0001). In addition, 69.2% of the 351 different combinations of an medication INN and a route of administration have no indication for the first month of life according to the French SmPC. Ninety-five percent of premature infants with GA less than 32 weeks received at least one medication not cited in SmPC. Conclusion Neonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.