Availability of age-appropriate paediatric formulations in the Netherlands: The need in daily clinical practice remains

Anna Van Der Vossen, Sandra Buljaç, Kadir Akçay, Jan Dietert Brugma*, Arnold Vulto, Lidwien Hanff

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

8 Citations (Scopus)
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Abstract

Objectives To quantify the availability of authorised, age-appropriate paediatric medicines in clinical practice in the Netherlands and to identify gaps by assessing dispensing practice in a paediatric hospital. Methods The availability of age-appropriate formulations was assessed by conducting a survey on the use of pharmacy compounded medicines among the paediatric hospitals in the Netherlands, and by analysing dispensing data of oral medication from the inpatient pharmacy of the largest paediatric hospital in the Netherlands. The age-appropriateness of the dispensed formulations was assessed on two aspects: dose-capability and acceptability. Liquid drug products that are unsuitable due to the presence of potentially harmful excipients, were identified based on the dosage in clinical practice. Results For 129 out of 139 drug substances included in the survey (93%), at least one of the eight respondents stated to use a pharmacy compounded product to meet the needs of their paediatric patients. The age-appropriateness of medicines dispensed from the inpatient pharmacy increased with age, and was higher for non-intensive care unit (ICU) patients than for ICU patients. We identified 15 drug products causing excipient exposure above the European Medicines Agency-recommended values. Conclusions This study confirms there is still a large need for age-appropriate formulations in daily clinical practice. Pharmacy compounding for paediatric patients remains essential for many indications. The need for potentially harmful excipients in compounded products should be critically assessed.

Original languageEnglish
Pages (from-to)306-312
Number of pages7
JournalEuropean Journal of Hospital Pharmacy
Volume28
Issue number6
DOIs
Publication statusPublished - 1 Nov 2021

Bibliographical note

Funding Information:
Acknowledgements The authors would like to thank the participating hospitals Radboud University Medical Center (Nijmegen), Academic Medical Center (Amsterdam), VU University Medical Center (Amsterdam), Leiden University Medical Center (Leiden), University Medical Center Utrecht (Utrecht), Maastricht University Medical Center+ (Maastricht) and Maxima Medical Center (Eindhoven). Contributors The authors have made substantial contribution to conception and design of the study (AvdV, SB, KA, JDB, AV, LH), acquisition of data (AvdV, SB, KA), analysis (AvdV, KA, SB) and interpretation (AvdV, SB, KA, JDB, AV, LH). Funding This study was funded by Royal Dutch Pharmacist Association. Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. data availability statement No data are available. Open access This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/ licenses/by/4.0/.

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© 2021 BMJ Publishing Group. All rights reserved.

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