GUEST EDITORIAL
Not just small adults …
Paediatrics is a unique and fulfilling area of pharmacy practice but challenges in overcoming the gaps in pharmaceutical care for these patients remain
A well-worn adage used in paediatrics is : “ children are not just small adults ”. Having paediatric-specific diseases ( for example , neuroblastoma , congenital heart diseases and juvenile onset diabetes ) and often requiring specific testing and special techniques or individualised frameworks for many procedures , we cannot deny that children are a very specific category of patients .
From a pharmacological point of view , paediatrics embraces a heterogenic group of patients under the age of 18 years . Monitoring and adjustment of therapy requires a detailed knowledge of variations in pharmacokinetics ( PK ) and pharmacodynamics ( PD ) as well as other factors that influence efficacy , such as absorption , formulation and administration . It is well known that PK processes , metabolism and excretion undergo changes during growth and development , while PD vary substantially within different age groups and disease states . Apart from being a heterogenous population , paediatrics embraces a constellation of different medical disciplines , many in constant evolution in terms of drug development and drug research ( such as in paediatric oncology , where numerous clinical trials with new drugs and cellular therapies are ongoing ).
Paediatric pharmacy is different , not only in terms of PK , PD and drug development , but also in other domains . Our colleagues involved in medical materials and devices know that even the size of the surgical equipment for children highlights the fact that they are a special group of patients .
Children are particularly at high-risk for medication errors and drug-related problems . Hospital pharmacists must be trained to ensure safe , effective and rational drug use to optimise treatment in different age groups . These factors add to the challenge of becoming a specialist in paediatric pharmacy . Apart from training , it is important for to stay up to date with current literature and participate in ongoing education , to develop a thorough knowledge of important developments in the field of paediatric pharmacology and pharmaceutical care .
6 | Issue 102 | hospitalpharmacyeurope . com
As part of the multidisciplinary team , the benefit of having one or more pharmacists on the paediatric ward and ( especially ) in the compounding units of the hospital pharmacy is invaluable
Tiene Bauters PharmD PhD Pharmacy ; Pediatric Hematology , Oncology and Stem Cell Transplantation , Ghent University Hospital , Ghent , Belgium
As part of the multidisciplinary team , the benefit of having one or more pharmacists on the paediatric ward and ( especially ) in the compounding units of the hospital pharmacy is invaluable . By providing age-appropriate formulations ( to overcome any hesistancy and reluctance children might have to take their medications ), they play a pivotal role in the safe and optimal use of drugs and improve quality and pharmacotherapeutic outcomes in paediatric units .
In recent years , there has been a growing interest in understanding patients ’ pharmacogenomic information . Genotypebased dosing recommendations are being developed and updated , so the need for paediatric pharmacists trained in this discipline has become essential .
From a hospital ’ s perspective , paediatric clinical pharmacists often serve on P & T committees working closely with other healthcare professionals . In this capacity , they are well positioned to develop and implement clinical decision support tools , guidelines and recommendations within the institution and tailor-made for specific paediatric disciplines . They boost collaboration by assisting prescribers , physician assistants ( especially in university centres ), and nurses as well as other members of the multidisciplinary team .
Finally , when looking at the number of ongoing clinical trials in paediatrics , the role of clinical pharmacists has certainly been well established , but there are still great opportunities for pharmacists specialising in this patient population .
So please don ’ t forget about the children ! Paediatrics is a unique and fulfilling area of pharmacy practice but challenges in overcoming the gaps in pharmaceutical care for these patients remain . To overcome these , let ’ s ensure that the required knowledge , skills and support is available to all pharmacists to allow them to develop innovative solutions and to reap the professional rewards of a gratifying career in improving pharmaceutical care for a special patient group .