Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study

doi:10.3389/fped.2021.747499

	Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study
	Zhang, Liwen 2; Hu, Yan 1; Pan, Panpan 2; Hong, Chengtao 2; Fang, Luo 1
刊名	FRONTIERS IN PEDIATRICS
	2021-10-29
卷号	9
关键词	capsule manipulation pediatric tablet prescription drug dose
ISSN号	2296-2360
DOI	10.3389/fped.2021.747499
通讯作者	Hong, Chengtao(85506598@qq.com) ; Fang, Luo(fangluo@zjcc.org.cn)
英文摘要	Objectives: To estimate the frequency of manipulations of all tablets and capsules prescribed for children in a teaching and tertiary children's hospital in China over the course of 1 month. Moreover, hypothetical reduction of manipulation according to the availability of low-strength tablets/capsules licensed by the Chinese National Medical Products Administration (CNMPA) was evaluated. Methods: Information on all tablets and capsules prescribed in the hospital from March 17 to April 16, 2019 was collected. It was assumed that tablets or capsules were manipulated if the prescribed dose would have required only a proportion of the intact dose form. Manipulation typically includes splitting or crushing tablets, opening capsules and dispersing in water, or combinations of these method. Moreover, we defined an "avoidable manipulation," when the dose could be rounded and/or when alternative products with a reduced strength or in liquid formulation were available in the hospital, and a "inappropriate manipulation," which involved manipulated medications with a direct contraindication for any manipulation, such as those with a narrow therapeutic index or hazardous ingredients, or modified release dosage-forms. The frequencies of total, avoidable, and inappropriate manipulation were estimated, along with the hypothetical reduction of manipulation according to the availability of CNMPA-approved drug doses. Results: A total of 17,123 prescriptions for 142 medications were identified to have required a manipulation among 78,366 prescriptions administered during the study period, with 43 different proportions of subdivisions, ranging from a 19/20 to 1/180 product strength reduction. Half, quarter, and trisection were the most common subdivisions administered. Overall, 19% of the manipulated prescriptions were determined to be avoidable, and 19% of the manipulations involved medications with a clear recommendation to not manipulate. In addition, 21% of the manipulated prescriptions could have been potentially avoided if all of the approved preparations with the lowest strength would have been available at the hospital. Any manipulations undertaken were carried out by pharmacists and family care givers. Conclusions: More than 20% of tablets and capsules prescriptions need manipulated, included a high incidence of avoidable and inappropriate manipulation.
资助项目	National Natural Science Foundation of China[81773819] ; National Natural Science Foundation of China[81973396] ; Natural Science Foundation of Zhejiang Province[Y16H160129] ; Natural Science Foundation of Zhejiang Province[LSY19H300001] ; Zhejiang Provincial Program for 151 Talents
WOS关键词	RELEASE ; BIOAVAILABILITY ; MEDICATIONS ; DISSOLUTION ; MEDICINES ; OUTCOMES ; IMPACT
WOS研究方向	Pediatrics
语种	英语
出版者	FRONTIERS MEDIA SA
WOS记录号	WOS:000717819400001
资助机构	National Natural Science Foundation of China ; Natural Science Foundation of Zhejiang Province ; Zhejiang Provincial Program for 151 Talents
内容类型	期刊论文
源URL	[http://ir.hfcas.ac.cn:8080/handle/334002/126508]
专题	中国科学院合肥物质科学研究院
通讯作者	Hong, Chengtao; Fang, Luo
作者单位	1.Chinese Acad Sci, Inst Basic Med & Canc IBMC, Zhejiang Canc Hosp, Canc Hosp,Univ Chinese Acad Sci,Dept Pharm, Hangzhou, Peoples R China 2.Zhejiang Univ, Childrens Hosp, Dept Pharm, Natl Clin Res Ctr Child Hlth,Sch Med, Hangzhou, Peoples R China
推荐引用方式 GB/T 7714	Zhang, Liwen,Hu, Yan,Pan, Panpan,et al. Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study[J]. FRONTIERS IN PEDIATRICS,2021,9.
APA	Zhang, Liwen,Hu, Yan,Pan, Panpan,Hong, Chengtao,&Fang, Luo.(2021).Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study.FRONTIERS IN PEDIATRICS,9.
MLA	Zhang, Liwen,et al."Estimated Manipulation of Tablets and Capsules to Meet Dose Requirements for Chinese Children: A Cross-Sectional Study".FRONTIERS IN PEDIATRICS 9(2021).