Development and validation by a Delphi method of a list of inappropriate prescribing in pediatric units in Cote d Ivoire

Inappropriate Prescribing (IP) may cause serious adverse drug events in pediatrics. A list of IPs taking into account frequently encountered pathologies and drugs, can be useful to optimize pediatric prescriptions. This study aims to develop and validate by a Delphi method, a list of IPs suitable to Ivorian pediatric context. Material and methods: A list of IPs was developed from prescription review of inpatients and outpatients aged 1 month to 16 years and followed in pediatrics units Teaching Hospitals of Abidjan during 16 months. A two-round Delphi method was used to validate a qualitative list of IPs by experts according to their level of agreement noted on a 6-point Liker scale ranging from 0 to 5 (0,No opinion; 5,Strongly agree). Only propositions obtaining a median score in the upper tertile with an agreement (rating 4 or 5) of more than 70% of experts who gave a non-zero rating for the first round and 80% for the second round-were retained. Results: A qualitative list of IPs was drawn up from 267 Drug Related Problems (DRPs) detected after prescription review of 4992 prescription lines for 881 patients. Our panel included 22 pediatricians (96%) and 1 clinical pharmacist (4%). At the end of the first round, all items submitted (54) were retained including 14 items reworded. In the second round, 20 experts participated and 52 IPs retained for final list including 44 inappropriate prescriptions and 8 omissions of prescription related to 22 pathologies/symptoms. Conclusion: The list of IPs developed and validated in this study should help to detect easily DRPs and optimize prescriptions in pediatric units in Cote d’Ivoire.