Drug prescribing and potential drug-drug interactions at the paediatric unit of a secondary health facility in Southern-Ijaw Local Government Area, Niger Delta Region, Nigeria

Background: Drug interactions resulting from multidrug prescribing can be desirable and/or non-desirable.

Objectives: To assess drug prescribing and potential drug-drug interactions at the paediatric unit of Amassoma General Hospital in the Southern-Ijaw Local Government Area, Bayelsa State, Niger Delta Area of Nigeria.

Methods: Retrospective evaluation of randomly selected 227 case notes of paediatric patients (aged, <12 years), who attended clinics at the study center from January 01 to December 31, 2020 was carried out. Pertinent data collected on diseases, medications prescribed, selected prescribing indicators, and potential drug-drug interactions (pDDIs) identified were presented descriptively, in simple percentages, mean, and median as appropriate. Where necessary, average values were compared using student-t test, and a p-value less than 0.05 was considered statistically significant.

Results: Each of the paediatric patients presented with average of 2.07 ± 0.79 diseases per encounter, and majority (252, 56.2%) were treated for infections. Average of 4.37 ± 1.73 drugs were ordered per encounter, and antiinfectives (423, 42.8%) were the most prescribed. All selected prescribing indicators were not within referenced standards, excluding encounters with injections prescribed (19.2%). A total of 160 (70.5%) of all 227 prescriptions vetted contained at least a pDDI. In all, average of 1.35 ± 1.28 pDDIs were observed per prescription, of which 0.93 ± 0.82 and 0.42 ± 0.77 (p < 0.05) were desirable and non-desirable, respectively. Adverse events (72, 74.2%) and reduction in effectiveness (25, 25.8%) of medication therapy constituted the main potential clinical consequences of non-desirable pDDIs identified.

Conclusion: The paediatric patients seen at the study center routinely present with infections, and were mostly prescribed anti-infective agents. Drug prescribing practice observed was grossly suboptimal and there were several cases of non-desirable pDDIs.