Assessing medication discrepancies in pediatric patients: a cross-sectional feasibility study using the Medication Discrepancy Taxonomy (MedTax) in a pediatric ward

Abstract

Background: Medication reconciliation (MedRec) is essential during transitions of care (ToC) to prevent errors, yet standardized tools to classify medication discrepancies are inconsistently applied in pediatrics. To address this gap, our study aims to assess the feasibility of the Medication Discrepancy Taxonomy (MedTax) in identifying and classifying medication discrepancies in pediatric patients during ToC. Methods: A prospective cross-sectional study was conducted on pediatric patients hospitalized between August 2022 and February 2023. Patients < 18 years, hospitalized for ≥ 24 h, and prescribed ≥ 1 medication were included. Pharmacist conducted MedRec during admissions and transfers, classifying discrepancies as intentional or unintentional; only unintentional discrepancies were further categorised using MedTax. Statistical analyses were performed using Jamovi version 1.6. Results: Among 105 patients (47.6% female; mean age 62.3 ± 61.3 months), the mean numbers of comorbidities and medications per patient were 0.75 ± 0.98 and 8.35 ± 5.56, respectively. In total, 518 medication discrepancies were identified, of which 47 (9.1%) were unintentional and 471 (90.9%) intentional. Among the unintentional discrepancies, 9 (19.2%) were partial and 38 (80.9%) were complete. All discrepancies were classified using MedTax, though 6.38% were difficult to categorize using the existing MedTax structure. Conclusion: This study shows the feasibility of using the MedTax taxonomy to identify and classify medication discrepancies in pediatric patients during ToC. While MedTax effectively categorized most discrepancies, challenges in classifying some highlight the need for refinement to address pediatric medication complexities. These findings emphasize the importance of developing tailored tools to improve medication reconciliation in pediatrics.