Effects of children's criteria for identifying potentially inappropriate prescribing on prescription review by pharmacists: a before-after study.

Background: We previously developed the children's potentially inappropriate prescribing (PIP) criteria to help detect and prevent inappropriate drug prescriptions in children.

Aim: To evaluate the impact of implementing the children's PIP criteria on pharmacists' pediatric prescription review processes.

Method: The prospectively before-after study was conducted in tertiary hospitals across China. In the control phase, pharmacists reviewed prescriptions based on their clinical experience without the involvement of children's PIP criteria. In the intervention phase, they implemented the children's PIP criteria to assist their review. Primary outcomes included the number of identified PIP before and after implementing the criteria and pharmacists' acceptance of the criteria. Secondary outcomes included inter-pharmacist consistency and the median time spent reviewing each case.

Results: Twenty-one pharmacists reviewed 362 drug prescriptions of 24 patients in two phases. The number of identified PIP increased from 26 (7.2%) in the control phase to 90 (24.9%) in the intervention phase (P < 0.001). The Fleiss Kappa value of inter-pharmacist consistency was enhanced from 0.182 to 0.262 after implementing the PIP criteria. Of 362 prescriptions, 280 had consistent review results across both phases, while 82 showed a change. The children's PIP criteria helped reduce review time by 1-8 min per case, saving a total of 55 min (P < 0.001).

Conclusion: The children's PIP criteria effectively assist pharmacists in identifying PIP during pediatric prescription review, improving inter-pharmacist consistency and reducing review time. These findings support broader adoption of the children's PIP criteria in clinical practice.