A systematic review of prescription errors in paediatric care

Abstract Background Prescription errors (PE) are more prone to occur in paediatric care due to weight-based dosing and age-specific formulations. The review aims to determine the prevalence of PE, factors associated and strategies employed to mitigate PE in paediatric care. Methodology This systemat...

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Bibliographic Details
Main Authors: GD Hannibal, NVNN Vithanage, MT Madhushika, TK Sinhabahu, I Kankananarachchi, PLGC Liyanage
Format: Article
Language:English
Published: BMC 2025-07-01
Series:BMC Health Services Research
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Online Access:https://doi.org/10.1186/s12913-025-13109-6
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Summary:Abstract Background Prescription errors (PE) are more prone to occur in paediatric care due to weight-based dosing and age-specific formulations. The review aims to determine the prevalence of PE, factors associated and strategies employed to mitigate PE in paediatric care. Methodology This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was conducted in MEDLINE and Cochrane databases using predefined terms related to prescribing errors and pediatric populations. Studies involving individuals under 18 years of age and focusing on prescribing errors in various healthcare settings were included. Two independent reviewers screened citations based on inclusion and exclusion criteria, resolving disagreements through discussion. Data extraction covered study characteristics, prescribing error types, associated factors, and preventive strategies. The quality of included studies was assessed using Allan and Barker’s criteria used in examining PE. Results The review included nine studies. Prevalence of PE varied from 22 to 70%. The most frequent PE type reported was dosing error (five out of nine articles) in both paediatric inpatient and emergency departments, whereas in outpatient settings it was inappropriate abbreviations. Antibiotics emerge as the most frequently implicated drug class. Only two articles have presented associated factors with PE. Parent factors such as poor health literacy (p < 0.001), language proficiency (p < 0.001), patient variables like age, weight, and other contextual factors including hospital stay, number of medications and medication administration methods were the main factors associated with PE (p < 0.05).The interventions that have shown statistically significant effectiveness in reducing PE were implementing e-learning resources, utilizing a color-coded method for dose determination, educating physicians and implementing templated prescriptions (p < 0.001). Conclusion This review highlights the high prevalence of prescribing errors in pediatric care, with dosing errors being the most common, particularly in inpatient and emergency settings. Antibiotics were the most frequently implicated drug class. Highlighting the preventable nature of these errors, our analysis confirms the need for further studies on PE focusing on factors affecting prescription errors and targeted interventions to reduce these errors in paediatric care.
ISSN:1472-6963