Pediatric Pharmacy

What Is The Role of a Pediatric Pharmacist?

Pediatric pharmacists are board-certified specialists working within an interdisciplinary team. To become a board-certified pediatric pharmacist after graduating from an accredited pharmacy program, you are required to pass the Pediatric Pharmacy Specialty Certification Examination after:

— Completing 4 years of practice experience as a licensed/registered pharmacist or completion of a PGY-1 residency +2 additional years of practice experience PLUS, at least 50% or more of that time spent practicing in the domains described in the Pediatric Pharmacy Content Outline.

OR

Completion of a specialty (PGY-2) residency in pediatric pharmacy.

The Role

Pediatric pharmacists advocate for and educate children and their families about medications, promote wellness and health to advance knowledge in pediatric pharmacy for patients as well as other health care providers. They ensure the safest and most effective use of drugs to provide desirable medication therapy outcomes in the pediatric population. Pharmacists in this area of practice accept that kids are not small adults. They understand the different pharmacokinetic (PK) and pharmacodynamic (PD) characteristics that pediatric patients possess.

The Importance of Pediatric Pharmacist

Pharmacists specialized in pediatrics have the skills required to help improve patient care. They know the various equations needed to calculate creatine clearance in children and the age-appropriate weight-based dose and rate of medications. As a member of an interdisciplinary team, a pediatric pharmacist can help answer drug information questions, and intercept medication errors to reduce mortality rates. They also have a financial impact on both hospitals and patients.

Medication errors have the capability to harm pediatric patients at a higher rate than in adult patients. The potential for adverse drug events within the pediatric inpatient population is about 3 times higher than the adult inpatient population. This is where pediatric pharmacists come in. A study evaluated the impact of pediatric pharmacists on decreasing medication errors at a pediatric teaching hospital. The results of the study found that 5.9% of the errors were medication errors on order, but only 0.2 % of those errors made it to the patient. Patient safety was improved due to interventions made by the pediatric pharmacist.

Reducing medication errors can also assist with decreasing a patient's length of stay (LOS) and overall costs for both the hospital and patients. One study compared the number of pediatric patients with cystic fibrosis achieving aminoglycoside PK/PD targets when a clinical pharmacist managed therapeutic drug monitoring to usual care. The study concluded, that patients being managed by clinical pharmacists resulted in a higher percentage of cystic fibrosis patients achieving aminoglycoside PK/PD targets 3 days sooner with an average LOS being 3 days shorter. Clinical pharmacist managed therapeutic drug monitoring resulted in fewer dosage adjustments, drug levels, and cost — associated with serum sampling, drug wastage, and LOS.

Conclusion

Specialized pharmacists working as part of an interdisciplinary team have a positive impact on the care of pediatric patients. Additionally, these pharmacists can help mitigate medication errors, patient LOS, and hospital costs while increasing overall patient drug safety.

References

1. Board Pharmacy Specialists. Pediatric Pharmacy. Available at: https://www.bpsweb.org/bps-specialties/pediatric-pharmacy/#1517746745397-c50604ba-9a311517780015777151785407768915178583338251517863453680. Accessed April 14, 2020.
2. Webster S, Kane C, Brown C, Warhurst H, Sedgley S, Slaughter W. Pediatric Pharmacy Services: Current Models and Justification for Expansion. J Pediatr Pharmacol Ther. 2019;24(5):438–444. DOI:10.5863/1551–6776–24.5.438
3. Cunningham KJ. Analysis of clinical interventions and the impact of pediatric pharmacists on medication error prevention in a teaching hospital. J Pediatr Pharmacol Ther. 2012;17(4):365–373. DOI:10.5863/1551–6776–17.4.365
4. Cies JJ, Varlotta L. Clinical pharmacist impact on care, length of stay, and cost in pediatric cystic fibrosis (CF) patients. Pediatr Pulmonol. 2013;48(12):1190–1194.

Thanks for reading.

Best,

-Aniya

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