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1. Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research.

Author

Béatrice Gouyon, Séverine Martin-Mons, Silvia Iacobelli, Hasinirina Razafimahefa, Elsa Kermorvant-Duchemin, Roselyne Brat, Laurence Caeymaex, Yvan Couringa, Ceneric Alexandre, Catherine Lafon, Duksha Ramful, Francesco Bonsante, Guillaume Binson, Florence Flamein, Amélie Moussy-Durandy, Massimo Di Maio, Gaël Mazeiras, Olivier Girard, Cécile Desbruyeres, Julien Mourdie, Guillaume Escourrou, Olivier Flechelles, Soumeth Abasse, Jean-Marc Rosenthal, Anne-Sophie Pages, Marine Dorsi, Léila Karaoui, Abdellah ElGellab, Florence Le Bail Dantec, Mohamed-Amine Yangui, Karine Norbert, Yaovi Kugbe, Simon Lorrain, Anaelle Pignolet, Elodie Marie Garnier, Alexandre Lapillonne, Delphine Mitanchez, Evelyne Jacqz-Aigrain, and Jean-Bernard Gouyon

Subjects
Medicine, Science
Abstract

ObjectivesThe 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 methodsThe 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.ResultsThe 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) (pConclusionNeonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.

Published
2019
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2. Characteristics of prescription in 29 Level 3 Neonatal Wards over a 2-year period (2017-2018). An inventory for future research

Author

Elsa Kermorvant-Duchemin, Guillaume Binson, Cécile Desbruyeres, Roselyne Brat, Evelyne Jacqz-Aigrain, Anne-Sophie Pages, Guillaume Escourrou, Duksha Ramful, Séverine Martin-Mons, Gaël Mazeiras, Amélie Moussy-Durandy, Julien Mourdie, Ceneric Alexandre, Francesco Bonsante, Marine Dorsi, Florence Le Bail Dantec, Laurence Caeymaex, Yaovi Kugbe, Olivier Flechelles, Soumeth Abasse, Béatrice Gouyon, Anaelle Pignolet, Massimo Di Maio, Abdellah ElGellab, Yvan Couringa, Mohamed-Amine Yangui, Elodie Marie Garnier, Alexandre Lapillonne, Karine Norbert, Catherine Lafon, Jean-Bernard Gouyon, Hasinirina Razafimahefa, Simon Lorrain, Silvia Iacobelli, Florence Flamein, Delphine Mitanchez, Léila Karaoui, Olivier Girard, Jean-Marc Rosenthal, Centre d'Études Périnatales de l'Océan Indien (CEPOI), Université de La Réunion (UR)-Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre Hospitalier Sud Francilien, CH Evry-Corbeil, CHU Necker - Enfants Malades [AP-HP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre Hospitalier Régional d'Orléans (CHRO), Centre Hospitalier Intercommunal de Créteil (CHIC), Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française], CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN), Groupe Hospitalier Artois-Ternois Centre Hospitalier d’Arras, Centre Hospitalier Universitaire de La Réunion (CHU La Réunion), Centre hospitalier universitaire de Poitiers (CHU Poitiers), CHU Lille, centre hospitalier intercommunal de Poissy/Saint-Germain-en-Laye - CHIPS [Poissy], Centre Hospitalier Universitaire de Nîmes (CHU Nîmes), Centre Hospitalier de Saint-Denis [Ile-de-France], Centre Hospitalier Métropole Savoie [Chambéry], Groupe Hospitalier du Havre Hôpital Jacques Monod (MONTIVILLIERS) (GHH), Centre Hospitalier Intercommunal André Grégoire [Montreuil] (CHI André Gregoire), Centre Hospitalier Universitaire de Martinique [Fort-de-France, Martinique], Centre Hospitalier de Mayotte, CHU Pointe-à-Pitre/Abymes [Guadeloupe], Centre Hospitalier Public du Cotentin (CHPC), Centre hospitalier territorial Gaston-Bourret [Nouméa], Grand Hôpital de l'Est Francilien (GHEF), Centre Hospitalier de Lens, Centre hospitalier Saint-Brieuc, Centre Hospitalier René Dubos [Pontoise], Centre hospitalier de Pau, Centre Hospitalier de l'Ouest Guyanais Franck Joly [Saint-Laurent-du-Maroni, Guyane Française], CHU Trousseau [APHP], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Hôpital Robert Debré, and Hôpital Robert Debré-Centre Hospitalier Universitaire de Reims (CHU Reims)

Subjects
Male, Pediatrics, Databases, Factual, Organic chemistry, Medication prescription, Neonatal Care, 0302 clinical medicine, Antibiotics, Medicine and Health Sciences, Medicine, 030212 general & internal medicine, Summary of Product Characteristics, Practice Patterns, Physicians', Vitamin D, Routes of Administration, Multidisciplinary, Antimicrobials, Gestational age, Drugs, Vitamins, 3. Good health, Chemistry, Physical Sciences, Female, Infant, Premature, Cohort study, Research Article, medicine.medical_specialty, Prescription Drugs, Science, Cardiology, Gestational Age, Drug Prescriptions, Microbiology, 03 medical and health sciences, Alkaloids, 030225 pediatrics, Caffeine, Microbial Control, Patients' Rooms, Organic compounds, Humans, Medical prescription, Retrospective Studies, Polypharmacy, Pharmacology, business.industry, Infant, Newborn, Chemical Compounds, Biology and Life Sciences, Neonates, Retrospective cohort study, Environmental Exposure, Health Care, [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie, Observational study, Neonatology, business, Developmental Biology
Abstract

ObjectivesThe 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 methodsThe 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.ResultsThe 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) (pConclusionNeonates remain therapeutic orphans. The consequences of polypharmacy in L3NW should be quickly assessed, especially in the most immature infants.

Published
2019

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