Progress made in mission to avoid side effects of medicines in children

Researchers develop tool to raise awareness

Researchers at the University of Central Lancashire (UCLan), Alder Hey Children’s Hospital, University of Liverpool and University College London have developed a tool that will raise awareness of potential side effects from medicines.

Medicines play a vital part in treating and preventing disease in adults and children. The aim is always to develop medicines that have no side effects (or adverse drug reactions as they are also called) but the reality is that all medicines can potentially cause unwanted effects in some people. Medicines affect people differently, especially children; due to the changes that take place as they grow and develop. When healthcare professionals prescribe a medicine, they weigh up the benefits of the medicine against any potential risk.

Previous research at Alder Hey found that three out of every 100 children admitted to hospital experience a reaction from a medicine taken at home. Most of these reactions were not severe and resolved soon after the medicine was stopped. However, 22% may have been avoidable, including side effects such as diarrhoea with antibiotics, constipation with medicines given to relieve pain and vomiting related to chemotherapy.

"Medicines can have different effects on different people. When healthcare professionals prescribe a medicine, they weigh up the benefits of the medicine against the risk of an adverse drug reaction (ADR)."

Around 1 in 6 children experienced at least one side effect from a medicine while in hospital, which is similar to findings in adults. More than half of the reactions seen in children in hospital were due to medicines used in general anaesthesia and for the treatment of pain after surgery. The five most common side effects were nausea and/or vomiting, itching, constipation, diarrhoea and sleepiness.

Dr Janine Arnott, a Senior Research Fellow in the UCLan School of Nursing who worked on the qualitative part of this study, said: “Medicines are an important part of treating and preventing disease in adults and children but occasionally medicines can cause unwanted side effects; what are sometimes called adverse drug reactions (ADRs).

“Medicines can have different effects on different people. When healthcare professionals prescribe a medicine, they weigh up the benefits of the medicine against the risk of an ADR. Children are not ‘mini adults’ – they process medicines differently to adults and this changes as they grow and develop. Because of this, we need to look at children as a special group when researching medicines and ADRs.”

Dr Louise Bracken, Research Pharmacist at the Paediatric Medicines Research Unit at Alder Hey Children’s Hospital said: “Assessing the avoidability of adverse drug reactions is a complex process which requires consideration of a number of factors. Identifying those side effects which might be avoidable can help us to improve practice which can then help to reduce the number of children who have an adverse drug reaction. The new tool will help us to identify the adverse drug reactions which we can prevent.”

"Identifying those side effects which might be avoidable can help us to improve practice which can then help to reduce the number of children who have an adverse drug reaction."

The use of technology (such as Electronic Prescribing), changing guidelines, educating patients and or/their parents on their medicines and raising awareness amongst healthcare professionals are some of the possible factors that may help. Advances in pharmacogenetics may represent the ultimate method of avoidability. Pharmacogenetics aims to optimise the use of medicines, by targeting medicines to patient's individual genes. This is called ‘personalised medicine’.

In the UK, the Medicines and Healthcare Products Regulatory Agency (MHRA) monitors the safety of medicines. If information indicates that the risk regarding a medicine has changed since it was authorised, regulatory bodies can take action. Health care professionals, patients and carers are encouraged to report side effects to the MHRA using the yellow card scheme http://yellowcard.mhra.gov.uk/. This can even be done now, using the Yellow Card App, helping to make medicines safer for children (and adults).