Potentially inappropriate prescribing among critically ill children: POPI-criteria in Russia

Vlasova AV1,2,3, Kulichenko TV4, Smirnova EV2
About authors

1 Russian Medical Academy of Continuous Professional Education of the Ministry of Healthcare of the Russian Federation, Moscow, Russia

2 Morozov Children's City Clinical Hospital, Moscow, Russia

3 Research Institute of Healthcare Organization and Medical Management, Moscow, Russia

4 Pirogov Russian National Research Medical University, Moscow, Russia

Correspondence should be addressed: Anna V. Vlasova
4th Dobryninsky pereulok, 1/9, Moscow,119049, Russia; ur.liam@57avosalvanna

About paper

Author contribution: Vlasova AV — study concept and design, data acquisition and processing, manuscript writing and editing; Smirnova EV — statistical data processing, manuscript editing; Kulichenko TV — manuscript editing.

Compliance with ethical standards: the study was approved by the Ethics Committee of the Morozov Children's City Clinical Hospital (the research protocol dated 24.10.2019 was published on ClinicalTrials.gov, ID: NCT04141657, Unique Protocol ID: 07819001, Brief Title: Safety Analysis of Antimicrobial Pharmacotherapy in Intensive Care Unit at Pediatric Hospital Official, Title: Observational Prospective Multidirectional Study on the Safety of Antimicrobial Pharmacotherapy in Intensive Care Unit (ICU) Children Aged 0-17).

Received: 2024-02-21 Accepted: 2024-04-27 Published online: 2024-04-30

The POPI criteria (Pediatrics: Omission of Prescriptions and Inappropriate prescriptions) for assessment of treatment of comorbidities, complications and underlying conditions in children that are accepted as the only existing instrument for detection of potentially inappropriate prescriptions, make it possible to evaluate prescriptions in children at the inpatient and outpatients stages of care provision, similar to the Beers criteria for adults. The study was aimed to assess the structure and rate of potentially inappropriate prescribing in the pediatric anesthesiology and resuscitation department of the multidisciplinary children's hospital based on the adapted version of  POPI criteria for non-antibiotic concomitant therapy of nosocomial infections. We analyzed 305 cases of non-antibiotic medication prescription per 100 patients included. The rate of potentially inappropriate prescribing was 31 cases (10.5%), among which potentially inappropriate medication was prescribed in 29 cases (9.5%), and potentially missed medication took place in three cases (1%). The highest rate of potentially inappropriate prescribing was reported for respiratory diseases. Assessment of concomitant therapy in the critically ill children with infections revealed no significant effects on the rate of adverse reactions to antibiotics in children. In the context of implementing medical information systems (MIS) and prescription sheets, integration of the adapted POPI criteria is topical in terms of maintaining the quality and safety of drug therapy for treatment of concomitant diseases, conditions, and complications in children.

Keywords: children, potentially inappropriate prescriptions, potentially missed medication, medication errors