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Dosing formulary for general paediatrics and neonatology during hospitalization – Is it possible to obtain a Belgian expert consensus using a Delphi method?

Christiaens, Audrey
(2023)

Files

ChristiaensAudrey_37261500_2023.pdf
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Details

Supervisors
Detaille, Thierry ; Marrant, Erwin
Faculty
Faculté de pharmacie et des sciences biomédicales
Degree label
Master de spécialisation en pharmacie hospitalière
Abstract
Background and objective Paediatrics is an at-risk population for several reasons: e.g., pharmacokinetics, drugs galenic, off label uses of medication. As for other populations, medication errors exist among the paediatric population, dosing errors are one of them. Different solutions are possible to decrease it, one would be to use a dosing formulary. The main objective of this study was to reach a consensus among a Belgian expert group on a paediatric and neonatal dosing formulary of 20 molecules, using a Delphi method. Methods Two Delphi methods nested together have been carried out to validate the formulary. The first one, Delphi (A), was designed to approve age categories, administration routes and indications suggested for a list of 20 molecules. These were selected after analysing drugs consumption from several hospitals in Belgium which have general paediatric or neonatal intensive care units. The second Delphi (B) aimed to validate neonatal and paediatric doses. The target expert panel consists of paediatricians, neonatologists and clinical pharmacists practicing in paediatrics or neonatology. A 5-level Likert scale was chosen. The validation criteria for Delphi A was defined as 70% of experts giving a score of 4 (= agree) or 5 (= strongly agree) on Likert scale and as 85% for Delphi B. Results Regarding Delphi A, nine experts completed the two rounds. All age categories, administration routes and indications (n = 60/60) were validated after two rounds (Delphi A). Concerning Delphi B, a total of 24,1% (n = 7/29) neonatal doses were validated after one round and 28,3% (n = 13/46) doses for paediatrics. Conclusion More rounds would be needed to improve the formulary in terms of age categories, administration routes, indications and to validate it for doses. Nevertheless, this study shows the opportunity of building a Belgian national paediatric and neonatal dosing formulary, and the project should be extended.