Methods for the detection of adverse drug reactions in hospitalized children: a systematic review

ABSTRACT

Introduction: Adverse drug reactions (ADR) are a problem for healthcare systems worldwide. Pediatric patients constitute a vulnerable group with regard to ADRs. However, although pediatric patients are at increased risk for these reactions, there is little progress on ADR detection methods in this group.

Areas covered: In this systematic search, performed according to PRISMA statements, we selected studies, published in PubMed/Medline databases; Scopus; LILACS; Web of Science; Embase and Cochrane Library until April, 2020, on ADRs in hospitalized pediatric patients.

Expert opinion: The increase of pediatric drug safety data is essential to the improvement of childcare. Health services must continuously stimulate educational programs focused on ADR detection tools to minimize the barriers and raise awareness among professionals. Therefore, it is necessary to consider that each method has advantages and disadvantages and must be analyzed in detail to be implemented according to the peculiarities of each practice scenario. Triggers tools (active method) correlated with electronic medical notes seems a good strategy for ADR identification, whether pediatric parameters are well checked and adapted with each age group. In any event, combined methods will add data to identification and clearer ADR assessment.

KEYWORDS:

• Adverse drug reactions
• hospitals
• children
• systematic review
• pharmacovigilance
• pediatrics

Article highlights

• The use of active methods, such as the combination of computerized systems, and review of medical notes, obtain better results in identifying ADR in hospitalized children.

• Spontaneous notification seems to be the method with the lowest rates of identification of ADR in hospitalized children. However, it is important to note that this method remains the first source of drug safety signs.

• Educational interventions can increase the awareness and participation of health professionals in detecting ADR in children.

• Most studies still use Naranjo’s tool to assess causality, although it has limitations regarding its applicability in clinical practice

• It is necessary to develop and improve the quality of methodologies for detecting specific ADRs for hospitalized children.

This box summarizes key points contained in the article.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Availability of data and material

The datasets used and/or analysed during the current study are available in the present manuscript.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/14740338.2021.1924668

Additional information

Funding

The authors received financial support for this research by National Council for Scientific and Technological (CNPq), Coordination for the Improvement of Higher Education Personnel-Brazil (CAPES) and the Foundation for Research and Technological Innovation Support of the State of Sergipe (FAPITEC).