Authors (including presenting author) :
Cheung WT(1), Wan TW (1), Chin HY(1), Leung SL (1), Yuen CM (1), Yung L (1), Chu LM(1), Wong LM (2), Yuen CL (2), Lee YC (2)
Affiliation :
(1) Department of Pharmacy, Tuen Mun Hospital, (2) Department of Paediatrics & Adolescent Medicine, Tuen Mun Hospital
Introduction :
Paediatric patients often require oral liquid dosage forms due to the need for smaller and flexible doses. However, the availability of liquid formulations in the market and hospital formularies is limited, and some paediatric patients under dietary restrictions, such as those on sugar-free or low-carbohydrate diets, cannot use syrup or other liquid dosage forms. As a result, the dissolution of solid dosage form, i.e. tablet and capsule has become a common practice especially in paediatric care. In practice, however, variability in dissolution methods adopted among healthcare staff exists. This can lead to inconsistent drug concentrations which confuse caregivers in drug administration, posing risks to medication safety and efficacy. To address the issue, “Recommendation of Dissolution Method of Oral Tablet/ Capsule” has been developed for commonly used solid medications in Tuen Mun Hospital.
Objectives :
(1) To establish a uniform dissolution practice for utilization by the clinical team (2) To offer clear and consistent instructions for paediatric patients and their caregivers (3) To mitigate medication error arising from variations in dissolution methods
Methodology :
“Recommendation of Dissolution Method of Oral Tablet/ Capsule” was implemented in the Pharmacy and wards. It outlines key parameters essential for dissolution, including the recommended strength of medications for dissolution, the specified volume of water required to dissolve each tablet or capsule, and the target concentration of the dissolved medication. In addition, a detailed step-by-step guide for computer entry was developed to provide clear and practical instructions for Dispensing staff engaged in outpatient dispensing activities. This guide ensured that accurate dissolution methods were recorded on medication labels for paediatric patients and their caregivers, facilitating proper medication administration and dosing at home. To address any changes resulting from the standardisation of dissolution methods, a proactive approach was taken to inform affected patients and their caregivers. Reminder notes were issued to patients, highlighting any modifications to their medication dissolution procedures. Furthermore, pharmacists conducted counselling sessions with caregivers to explain the change and address any concerns or questions that arose.
Result & Outcome :
This initiative has established a consistent and structured approach to medication dissolution for paediatric patients in the hospital setting. The implementation of the “Recommendation” and computer entry guide ensured that healthcare staff were equipped with the necessary tools and instructions to adhere to standardised dissolution practice. Through minimizing variability in medication administration, dosing accuracy and medication safety in paediatric care are enhanced.
