Charles Sparrow
Casey Hospital, Monash Childrens Hospital, Melbourne, Australia
Title: How do doctors calculate medication doses in childhood obesity? A retrosepctive evaluation of prescriptions in paediatric patients in Casey Hosptial, Melbourne
Biography
Biography: Charles Sparrow
Abstract
Introduction - Pharmaceutical errors are a leading cause of unwanted side effects in paediatrics. With rising levels of childhood obesity worldwide, larger drug doses are being prescribed based on total body weight. To minimise harm, the Ideal Body Weight (IBW) is one suggested method for weight based calculations of certain medications in children, but not routinely used. We investigated the number of overweight children receiving medication doses based on IBW, and those on total body weight (TBW) in a paediatric ward in Melbourne, Australia.
Method - We performed a retrospective audit of children admitted as an inpatient over 1 month (January–Februrary 2019) and calculated those classified as overweight (>90th centile for weight on CDC growth charts). We used Scanned Medical Records to locate the data for each patient, and subsequently determined their weight, medications given, and if the calculated doses were based on IBW or TBW.
Results - 56 overweight patients were used, from an initial 126. 6 different medications were prescribed, of which 3.7% (n=2) doses were based on IBW, with 96.3% (n=54) prescribed based on the TBW. Paracetamol (n=45, TBW 95.6%, IBW 4.47%), and Ibuprofen (n=28, IBW 7.1%, TBW 92.9%) were the most common medications prescribed.
Conclusion - We are poor at prescribing medications based on IBW, with the majority of children prescribed doses based on TBW. Following this audit, we have created a proforma to be used to ensure the correct method of dosing is used for specific medications, to reduce potential long term side effects.