AAP supports electronic prescribing systems

In a newly released policy statement, the American Academy of Pediatrics (AAP) recommends the adoption of electronic prescribing (e-prescribing) systems with pediatric functionality as a means to improving quality and safety in pediatric care.

Medication prescribing for children is an error-prone process that can lead to adverse events, says the policy statement. In a previous systematic review, researchers found prescribing error rates for children of between 3% and 37%, most commonly with antibiotics but occurring even for medications that did not require weight-based dosing.

E-prescribing, which transmits prescriptions electronically to a pharmacy, is recognized as a care process that improves quality and safety for medication administration by reducing dosing errors, avoiding adverse effects, improving communication with pharmacies, and improving overall efficiency. However, AAP says that many existing e-prescribing software systems are poorly designed for pediatric patients.

The statement recommends that pediatric e-prescribing systems should include pediatric-specific medication catalogs; weight-based dose calculations; individual and daily dose alerts; rounding; ingredient amount-to-volume conversions for liquid medications; metric-only labeling instructions; pediatric drug information and formulary options; drug-to-drug interactions; and allergy checking.

In addition, e-prescribing systems, whether stand-alone or integrated with electronic health records, should be able to provide patients and their parents with instructions for administering medications based on their level of health literacy and in their preferred language.

The AAP also calls upon pharmacies to ensure that their infrastructures and workflows are able to accept and process e-prescriptions generated and transmitted by certified health information technology systems and to perform independent and redundant dose-range checks for all medications.

The AAP policy statement was accompanied by a technical report that more fully describes the rationale behind the statement and the evidence base supporting e-prescribing systems’ limitations and potential benefits.