Characterization of children's prospective prescription review and exploration of factors influencing the success of interventions

Ther Adv Drug Saf. 2025 Jan 6:16:20420986241311448. doi: 10.1177/20420986241311448. eCollection 2025.

Abstract

Background: Medication safety is crucial in clinical care. Although many hospitals have implemented prospective prescription review systems to manage medication use, the impact of these systems on pediatric patients is not yet fully understood.

Objectives: We explore the characteristics and economic impacts of pediatric prospective prescription review and identify factors influencing intervention success rates.

Design: This study adopted a cross-sectional design.

Methods: Prospective prescription review tasks were compared in the outpatient of our hospital between 2021 and 2023 to assess medication rationalization rates and cost variability. Data were collected using the PASS PharmReview system, including patient information, medication indications, prescribing physicians, intervention pharmacists, prescription rationality rate, and medication costs. SPSS 26.0 software was used to compare changes in medication rationality and medication costs between the initial (2021) and stable (2023) periods and to analyze factors affecting intervention success during the stable period by the logistic regression model.

Results: The study included 11,533,807 prospective prescription review tasks. The medication rationalization rate increased from 92.0% to 95.7% (p < 0.05) between the initial (n = 5,392,551) and stabilization periods (n = 6,141,256). Outpatient medication costs per capita decreased by 3.2%, from ¥320.7 to ¥310.5. Factors influencing intervention success included the following: the greater age is negatively associated with success(p < 0.001, odds ratio (OR) = 0.98); internal medicine demonstrates a superior intervention success rate compared to the surgical department (p < 0.001, OR = 1.37); higher physician titles were associated with lower success rates (p < 0.001, OR = 0.59); and success increased with pharmacists of higher educational levels (p < 0.001, OR = 1.18).

Conclusion: Implementing a prospective prescription review system in pediatric outpatient settings improves medication rationality and reduces errors and costs, with intervention success influenced by patient age, department, physician titles, and the educational level of pharmacists.

Keywords: characterization; children; impact factors; intervention; prospective prescription review.

Plain language summary

Pediatric prescription reviews: success factors and safety improvements Why was the study done? Children’s medication safety is crucial in healthcare. Many hospitals now check prescriptions by prospective review model to make sure they’re safe for children, but we still need to understand how effective this process is and what makes it work better. This study looked into these questions. What did the researchers do? The researchers studied how prescriptions were reviewed in the outpatient department of a pediatric hospital between 2021 and 2023. They collected data on patients, medications, doctors, and costs. Their study compared prescription rationality and medication costs, employing statistical methods to identify factors contributing to more successful intervene prospective review outcomes. What did the researchers find? Out of 11.5 million reviews, appropriate prescriptions increased from 92.0% in 2021 to 95.7% in 2023. Medication costs per patient dropped by 3.2%. Some factors affected review success: Older children’s prescriptions were reviewed less successfully. Internal medicine prescriptions were more successful than surgical ones. Doctors with higher titles had lower success rates, whereas pharmacists with more education were more successful. What do the findings mean? Prospective prescription review can enhance safety and reduce costs for children. Factors like a child’s age, the doctor’s department, doctor’s title, and pharmacist’s education level affect review success. This information can help improve the way medications are managed for children in outpatient settings.