Drug-related problems in pediatric patients with chronic kidney disease: A single-center prospective study.

Abstract

Currently, there is a lack of data on drug-related problems (DRPs) in pediatric patients with chronic kidney disease (CKD) in China. The aim of the present study was to determine the incidence and determinants of DRPs in pediatric patients with CKD and to inform evidence-based pharmacotherapy for this population. For this purpose, a single-center prospective study was conducted at the Guiyang Maternal and Child Health Care Hospital (Guiyang, China) between January and December 2023. The Pharmaceutical Care Network Europe (PCNE) taxonomy [version 9.1 (v9.1)] was adapted to reflect the unique characteristics of pediatric patients with CKD; all identified DRPs were classified according to the modified PCNE v9.1 and were subsequently analyzed. The results demonstrated that among the 383 hospitalized children with CKD, 136 patients (35.51%) experienced 203 DRPs; the majority of problems pertained to treatment effectiveness (190; 93.60%) and of the 223 underlying causes identified, 79 (35.43%) were related to drug selection. Clinical pharmacists initiated 254 interventions; 243 (95.67%) were fully accepted and implemented. In conclusion, the present study demonstrated that DRPs are common in pediatric patients with CKD. The implementation of a pharmacist-led medication reconciliation model, supported by an adapted PCNE tool, was associated with a high intervention acceptance rate. However, the present study was conducted in a single center and the findings obtained need to be validated in other centers, thereby providing more valuable references for the identification and management of DRPs in children with CKD.