Medication Related Problems Among Critically Ill Neonates Admitted at Kenyatta National Hospital a Prospective Cohort Study
Abstract
Background: Neonates are usually at a significant risk for adverse risk for adverse drug
reactions since organs required to handle medicine are still under development. Neonates at the
neonatal intensive care unit are usually very ill with multiple organ dysfunction. They may be on
multiple medications which greatly increases the chances of adverse drug reactions.
Objective: The main objective of the study was to characterize the medication related problems
and their associated factors among the neonates admitted to the intensive care units of Kenyatta
National Hospital.
Methods: The study was carried out between April and June 2019 and it was a descriptive
prospective cohort study. It entailed the prospective review of treatment sheets and patient files
of neonatal patients who are critically ill and admitted at the Kenyatta National Hospital. Data
collection commenced within 48 hours of admission. Data collection was done by reviewing
patient files to extract details such as demographic characteristics and clinical data on medication
related problems. Patient records were reviewed daily. Follow-up was done daily for two weeks.
Descriptive data analysis was conducted. The relationships between predictor and outcome
variables for medication related problems was computed using logistic regression to identify risk
factors for Medication Related Problems. The level of significance was set at 0.05.
Results: A total of 70 participants met the eligibility criteria and were enrolled into the study.
The most common diagnosis was respiratory distress syndrome (64, (88.8%), which was
followed by infections (81.1%). Benzyl penicillin (52, (19%), gentamicin (50, (18.2%) and
ceftazidime 32(11.7%) were the most prescribed antibiotics. Aminophylline (21, (5.5%) was the
most prescribed respiratory drug. Dosing errors were evaluated and they were most likely to
have a negative impact on treatment outcomes. Gastrointestinal (OR 1.5 95% CI 1.038, 2.165;
p=0.031) and congenital disorders (OR 1.368 95% CI 1.018, 1.837; p=0.037) were strong
predictors of underdosing. There was statistical significant association between the use of
aminophylline, ranitidine, phenytoin and overdosing. There was no statistical significant between
dosing errors and anthropometric measures.
Conclusion: Dosing errors are the most common MRP among critically ill neonates admitted in
the neonatal intensive care unit. Specialist pharmaceutical care is needed to identify and manage
MRPs.
Publisher
university of nairobi
Subject
Critically Ill NeonatesRights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
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