Assessment of prescribing in under-five paediatric outpatients in Nigeria: an application of the POPI (Pediatrics: Omission of Prescription and Inappropriate Prescription) tool

OBJECTIVES: This study evaluated prescribing in children under the age of five attending paediatric outpatient clinics at three Central hospitals in Delta State, Nigeria and determined the conditions mostly associated with inappropriate prescriptions and omissions. METHODS: This was a retrospective study of prescriptions made to children from 0 to 59 months who attended the clinics. Prescriptions were evaluated using the POPI tool, occurrence of potentially inappropriate prescriptions and prescribing omissions were reported as percentages and inappropriate prescription types and prescription omissions were also reported as frequencies. Relationship between inappropriate prescriptions, omissions of prescriptions and age group and gender were determined, P < 0.05 was considered significant. KEY FINDINGS: A total of 1327 prescriptions from the three centres were analyzed. There was a preponderance of infants (>1 month-12 months of age) in the study (43.0%) and a somewhat even gender distribution. Exactly 29.8% of all the prescriptions studied had at least one occurrence of inappropriate prescription. The use of H1 antagonists with sedative or atropine-like effects accounted for the majority of inappropriate prescriptions (49.5%), while the prescription of drinkable amoxicillin or other antibiotics in doses other than mg was the most frequent omission of prescription (97.2%). There was a significant relationship between the occurrence of inappropriate prescription and age group (P > 0.001). CONCLUSIONS: Inappropriate prescriptions and omissions of prescriptions were high and effectively detected by the POPI tool.