Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study

Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age [greater than or equal to] 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs an...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2022-11, Vol.17 (11), p.e0275655-e0275655
Main Authors: Ambreen, Gul, Kumar, Manoj, Ali, Amin, Shah, Syed Akbar Ali, Saleem, Syed Muzafar, Tahir, Ayesha, Salat, Muhammad Sohail, Aslam, Muhammad Shahzad, Hussain, Kashif
Format: Article
Language:English
Subjects:
Apnea
Apnea neonatorum
Biology and Life Sciences
Caffeine
Care and treatment
Diagnosis
Dosage
Drug dosages
Drugs
Evaluation
Extubation
Gestational age
Health aspects
Health risks
Infants (Premature)
Medication adherence
Medicine and Health Sciences
Multiple births
Multivariate analysis
Neonates
Newborn babies
Patient compliance
Pediatrics
People and Places
Pharmacists
Physical Sciences
Quality control
Quasi-experimental methods
Risk analysis
Risk factors
Services
Socioeconomic factors
Tertiary
Therapy
Ventilators
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53
cites cdi_FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53
container_end_page e0275655
container_issue 11
container_start_page e0275655
container_title PloS one
container_volume 17
creator Ambreen, Gul
Kumar, Manoj
Ali, Amin
Shah, Syed Akbar Ali
Saleem, Syed Muzafar
Tahir, Ayesha
Salat, Muhammad Sohail
Aslam, Muhammad Shahzad
Hussain, Kashif
description Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age [greater than or equal to] 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p
doi_str_mv 10.1371/journal.pone.0275655
format article
fullrecord <record><control><sourceid>gale_plos_</sourceid><recordid>TN_cdi_plos_journals_2734593548</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A725966565</galeid><sourcerecordid>A725966565</sourcerecordid><originalsourceid>FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53</originalsourceid><addsrcrecordid>eNqNk99qFDEUxgdRbK2-gWBAEL2YNTOZZGZ7ISylaqFQ8N9tOE3O7KZmkmkyU7ov5vOZ6Y7SlV5ILhKS3_nOyZecLHtZ0EXB6uL9lR-DA7vovcMFLWsuOH-UHRZLVuaipOzxvfVB9izGK0o5a4R4mh0wwTht6vow-3V6A3aEwXhHfEv6DYQOFI6DUWDtlijf9X50GjXxASxR0LZoHJLEDxskputBDVNohzrF3AmB3mBAp5CA0ySY-HMCAoLuTIx3ROfdmvQBBwwdcegdDBiPyYpE49YWc4UuHZHrEaLJ8bbHYLq0lSqIw6i3z7MnLdiIL-b5KPv-8fTbyef8_OLT2cnqPFeCsiHX0FCERutaUFUvdc1LqDijCouyaFjTtLzmqOhlw4TA9pLDkrKS61phRUvN2VH2aqfbWx_lbHmUZc0qvmS8ahLxYSbGy2TBVHfySfapXghb6cHI_RNnNnLtb-RSVOnJRBJ4OwsEfz1iHGQySaG1kGwZd7lEwUo65Xr9D_pwRTO1BovSuNanvGoSlau65EuRsk43WzxApaGxMyr9qdak_b2Ad3sBiRnwdljDGKM8-_rl_9mLH_vsm3vsBsEOm-jtOP2kuA9WO1AFH2PA9q_JBZVTS_xxQ04tIeeWYL8BgEEBnA</addsrcrecordid><sourcetype>Open Website</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2734593548</pqid></control><display><type>article</type><title>Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study</title><source>PMC (PubMed Central)</source><source>Publicly Available Content (ProQuest)</source><creator>Ambreen, Gul ; Kumar, Manoj ; Ali, Amin ; Shah, Syed Akbar Ali ; Saleem, Syed Muzafar ; Tahir, Ayesha ; Salat, Muhammad Sohail ; Aslam, Muhammad Shahzad ; Hussain, Kashif</creator><contributor>Baratta, Francesca</contributor><creatorcontrib>Ambreen, Gul ; Kumar, Manoj ; Ali, Amin ; Shah, Syed Akbar Ali ; Saleem, Syed Muzafar ; Tahir, Ayesha ; Salat, Muhammad Sohail ; Aslam, Muhammad Shahzad ; Hussain, Kashif ; Baratta, Francesca</creatorcontrib><description>Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age [greater than or equal to] 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p&lt;0.001), significantly higher (p&lt;0.001) number of patients completed remaining refills (77.6% pre-phase vs 97.5% post-phase). The number of parental complaints about cost, ampoule usage, medication drawing issue, wastage, inappropriate dosage form, and longer duration of therapy reduced significantly in post-phase. HRA reduced from 25% to 6.6% (p&lt;0.001). Post-implementation of PCC (RR 0.14; 95% CI: 0.07-0.27) was a significant independent risk factor for reducing HRA using a multivariate analysis model. Longer duration of caffeine therapy after discharge (RR 1.05; 95% CI: 1.04-1.04), those who were born in multiple births (RR 1.15; 95% CI: 1.15-1.15), and those who had higher number of siblings were other significant independent risk factors for HRA. PCC dispensation in the appropriate dosage form at discharge effectively reduced cost, non-adherence to therapy, and risk of hospital readmissions. This neonatal clinical and compounding pharmacist-led model can be replicated in other resource-limiting setting.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0275655</identifier><identifier>PMID: 36350877</identifier><language>eng</language><publisher>San Francisco: Public Library of Science</publisher><subject>Apnea ; Apnea neonatorum ; Biology and Life Sciences ; Caffeine ; Care and treatment ; Diagnosis ; Dosage ; Drug dosages ; Drugs ; Evaluation ; Extubation ; Gestational age ; Health aspects ; Health risks ; Infants (Premature) ; Medication adherence ; Medicine and Health Sciences ; Multiple births ; Multivariate analysis ; Neonates ; Newborn babies ; Patient compliance ; Pediatrics ; People and Places ; Pharmacists ; Physical Sciences ; Quality control ; Quasi-experimental methods ; Risk analysis ; Risk factors ; Services ; Socioeconomic factors ; Tertiary ; Therapy ; Ventilators</subject><ispartof>PloS one, 2022-11, Vol.17 (11), p.e0275655-e0275655</ispartof><rights>COPYRIGHT 2022 Public Library of Science</rights><rights>2022 Ambreen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 Ambreen et al 2022 Ambreen et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53</citedby><cites>FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53</cites><orcidid>0000-0003-2728-6726 ; 0000-0002-6287-6898</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2734593548/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2734593548?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids></links><search><contributor>Baratta, Francesca</contributor><creatorcontrib>Ambreen, Gul</creatorcontrib><creatorcontrib>Kumar, Manoj</creatorcontrib><creatorcontrib>Ali, Amin</creatorcontrib><creatorcontrib>Shah, Syed Akbar Ali</creatorcontrib><creatorcontrib>Saleem, Syed Muzafar</creatorcontrib><creatorcontrib>Tahir, Ayesha</creatorcontrib><creatorcontrib>Salat, Muhammad Sohail</creatorcontrib><creatorcontrib>Aslam, Muhammad Shahzad</creatorcontrib><creatorcontrib>Hussain, Kashif</creatorcontrib><title>Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study</title><title>PloS one</title><description>Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age [greater than or equal to] 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p&lt;0.001), significantly higher (p&lt;0.001) number of patients completed remaining refills (77.6% pre-phase vs 97.5% post-phase). The number of parental complaints about cost, ampoule usage, medication drawing issue, wastage, inappropriate dosage form, and longer duration of therapy reduced significantly in post-phase. HRA reduced from 25% to 6.6% (p&lt;0.001). Post-implementation of PCC (RR 0.14; 95% CI: 0.07-0.27) was a significant independent risk factor for reducing HRA using a multivariate analysis model. Longer duration of caffeine therapy after discharge (RR 1.05; 95% CI: 1.04-1.04), those who were born in multiple births (RR 1.15; 95% CI: 1.15-1.15), and those who had higher number of siblings were other significant independent risk factors for HRA. PCC dispensation in the appropriate dosage form at discharge effectively reduced cost, non-adherence to therapy, and risk of hospital readmissions. This neonatal clinical and compounding pharmacist-led model can be replicated in other resource-limiting setting.</description><subject>Apnea</subject><subject>Apnea neonatorum</subject><subject>Biology and Life Sciences</subject><subject>Caffeine</subject><subject>Care and treatment</subject><subject>Diagnosis</subject><subject>Dosage</subject><subject>Drug dosages</subject><subject>Drugs</subject><subject>Evaluation</subject><subject>Extubation</subject><subject>Gestational age</subject><subject>Health aspects</subject><subject>Health risks</subject><subject>Infants (Premature)</subject><subject>Medication adherence</subject><subject>Medicine and Health Sciences</subject><subject>Multiple births</subject><subject>Multivariate analysis</subject><subject>Neonates</subject><subject>Newborn babies</subject><subject>Patient compliance</subject><subject>Pediatrics</subject><subject>People and Places</subject><subject>Pharmacists</subject><subject>Physical Sciences</subject><subject>Quality control</subject><subject>Quasi-experimental methods</subject><subject>Risk analysis</subject><subject>Risk factors</subject><subject>Services</subject><subject>Socioeconomic factors</subject><subject>Tertiary</subject><subject>Therapy</subject><subject>Ventilators</subject><issn>1932-6203</issn><issn>1932-6203</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNqNk99qFDEUxgdRbK2-gWBAEL2YNTOZZGZ7ISylaqFQ8N9tOE3O7KZmkmkyU7ov5vOZ6Y7SlV5ILhKS3_nOyZecLHtZ0EXB6uL9lR-DA7vovcMFLWsuOH-UHRZLVuaipOzxvfVB9izGK0o5a4R4mh0wwTht6vow-3V6A3aEwXhHfEv6DYQOFI6DUWDtlijf9X50GjXxASxR0LZoHJLEDxskputBDVNohzrF3AmB3mBAp5CA0ySY-HMCAoLuTIx3ROfdmvQBBwwdcegdDBiPyYpE49YWc4UuHZHrEaLJ8bbHYLq0lSqIw6i3z7MnLdiIL-b5KPv-8fTbyef8_OLT2cnqPFeCsiHX0FCERutaUFUvdc1LqDijCouyaFjTtLzmqOhlw4TA9pLDkrKS61phRUvN2VH2aqfbWx_lbHmUZc0qvmS8ahLxYSbGy2TBVHfySfapXghb6cHI_RNnNnLtb-RSVOnJRBJ4OwsEfz1iHGQySaG1kGwZd7lEwUo65Xr9D_pwRTO1BovSuNanvGoSlau65EuRsk43WzxApaGxMyr9qdak_b2Ad3sBiRnwdljDGKM8-_rl_9mLH_vsm3vsBsEOm-jtOP2kuA9WO1AFH2PA9q_JBZVTS_xxQ04tIeeWYL8BgEEBnA</recordid><startdate>20221109</startdate><enddate>20221109</enddate><creator>Ambreen, Gul</creator><creator>Kumar, Manoj</creator><creator>Ali, Amin</creator><creator>Shah, Syed Akbar Ali</creator><creator>Saleem, Syed Muzafar</creator><creator>Tahir, Ayesha</creator><creator>Salat, Muhammad Sohail</creator><creator>Aslam, Muhammad Shahzad</creator><creator>Hussain, Kashif</creator><general>Public Library of Science</general><scope>AAYXX</scope><scope>CITATION</scope><scope>IOV</scope><scope>ISR</scope><scope>3V.</scope><scope>7QG</scope><scope>7QL</scope><scope>7QO</scope><scope>7RV</scope><scope>7SN</scope><scope>7SS</scope><scope>7T5</scope><scope>7TG</scope><scope>7TM</scope><scope>7U9</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>KB0</scope><scope>KL.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>M7S</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PDBOC</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>RC3</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-2728-6726</orcidid><orcidid>https://orcid.org/0000-0002-6287-6898</orcidid></search><sort><creationdate>20221109</creationdate><title>Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study</title><author>Ambreen, Gul ; Kumar, Manoj ; Ali, Amin ; Shah, Syed Akbar Ali ; Saleem, Syed Muzafar ; Tahir, Ayesha ; Salat, Muhammad Sohail ; Aslam, Muhammad Shahzad ; Hussain, Kashif</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>Apnea</topic><topic>Apnea neonatorum</topic><topic>Biology and Life Sciences</topic><topic>Caffeine</topic><topic>Care and treatment</topic><topic>Diagnosis</topic><topic>Dosage</topic><topic>Drug dosages</topic><topic>Drugs</topic><topic>Evaluation</topic><topic>Extubation</topic><topic>Gestational age</topic><topic>Health aspects</topic><topic>Health risks</topic><topic>Infants (Premature)</topic><topic>Medication adherence</topic><topic>Medicine and Health Sciences</topic><topic>Multiple births</topic><topic>Multivariate analysis</topic><topic>Neonates</topic><topic>Newborn babies</topic><topic>Patient compliance</topic><topic>Pediatrics</topic><topic>People and Places</topic><topic>Pharmacists</topic><topic>Physical Sciences</topic><topic>Quality control</topic><topic>Quasi-experimental methods</topic><topic>Risk analysis</topic><topic>Risk factors</topic><topic>Services</topic><topic>Socioeconomic factors</topic><topic>Tertiary</topic><topic>Therapy</topic><topic>Ventilators</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ambreen, Gul</creatorcontrib><creatorcontrib>Kumar, Manoj</creatorcontrib><creatorcontrib>Ali, Amin</creatorcontrib><creatorcontrib>Shah, Syed Akbar Ali</creatorcontrib><creatorcontrib>Saleem, Syed Muzafar</creatorcontrib><creatorcontrib>Tahir, Ayesha</creatorcontrib><creatorcontrib>Salat, Muhammad Sohail</creatorcontrib><creatorcontrib>Aslam, Muhammad Shahzad</creatorcontrib><creatorcontrib>Hussain, Kashif</creatorcontrib><collection>CrossRef</collection><collection>Opposing Viewpoints Resource Center</collection><collection>Gale In Context: Science</collection><collection>ProQuest Central (Corporate)</collection><collection>Animal Behavior Abstracts</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing &amp; Allied Health Database (ProQuest)</collection><collection>Ecology Abstracts</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Immunology Abstracts</collection><collection>Meteorological &amp; Geoastrophysical Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Agricultural Science Collection</collection><collection>Health &amp; Medical Collection (Proquest)</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest Public Health Database</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Materials Science &amp; Engineering Database (Proquest)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central</collection><collection>Advanced Technologies &amp; Aerospace Database‎ (1962 - current)</collection><collection>Agricultural &amp; Environmental Science Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Materials Science Collection</collection><collection>ProQuest Central</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>https://resources.nclive.org/materials</collection><collection>Nursing &amp; Allied Health Database (Alumni Edition)</collection><collection>Meteorological &amp; Geoastrophysical Abstracts - Academic</collection><collection>ProQuest Engineering Collection</collection><collection>ProQuest Biological Science Collection</collection><collection>Agriculture Science Database</collection><collection>Health &amp; Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>ProQuest Engineering Database</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>ProQuest advanced technologies &amp; aerospace journals</collection><collection>ProQuest Advanced Technologies &amp; Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Environmental Science Database</collection><collection>Materials Science Collection</collection><collection>Publicly Available Content (ProQuest)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>Engineering collection</collection><collection>Environmental Science Collection</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ambreen, Gul</au><au>Kumar, Manoj</au><au>Ali, Amin</au><au>Shah, Syed Akbar Ali</au><au>Saleem, Syed Muzafar</au><au>Tahir, Ayesha</au><au>Salat, Muhammad Sohail</au><au>Aslam, Muhammad Shahzad</au><au>Hussain, Kashif</au><au>Baratta, Francesca</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study</atitle><jtitle>PloS one</jtitle><date>2022-11-09</date><risdate>2022</risdate><volume>17</volume><issue>11</issue><spage>e0275655</spage><epage>e0275655</epage><pages>e0275655-e0275655</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Caffeine is available in an ampoule, used via parenteral and enteral routes in preterm neonates to treat apnea of prematurity (AOP) in neonates of gestational age [greater than or equal to] 35-40 weeks. A longer duration of therapy has a higher risk of medication non-adherence due to higher costs and inappropriate dosage forms. Pharmaceutically compounded oral caffeine (PCC) could be an appropriate alternate dosage form. The researchers aimed to determine the impact of PCC on medication-related factors influencing medication adherence (MA) and the frequency of hospital readmission with apnea (HRA) in preterm neonates. We conducted a single-center quasi-experimental study for this quality improvement project using PCC among the preterm neonates admitted in a tertiary care level-III NICU at the Aga Khan University Hospital Karachi, Pakistan, received caffeine therapy, and survived at discharge. The researchers compared pre-PCC data (April-December 2017) with post-PCC data (April-Dec 2018) each for nine months, with three months intervals (January-March 2018) of PCC formulation and implementation phase. The study was conducted according to the SQUIRE2.0 guidelines. The Data were collated on factors influencing MA, including the cost of therapy, medication refill rates, and parental complaints as primary outcome measures. The Risk factors of HRA were included as secondary outcomes. After PCC implementation cost of therapy was reduced significantly from Rs. 97000.0 (729.0 USD) to Rs. 24500.0 (185.0 USD) (p&lt;0.001), significantly higher (p&lt;0.001) number of patients completed remaining refills (77.6% pre-phase vs 97.5% post-phase). The number of parental complaints about cost, ampoule usage, medication drawing issue, wastage, inappropriate dosage form, and longer duration of therapy reduced significantly in post-phase. HRA reduced from 25% to 6.6% (p&lt;0.001). Post-implementation of PCC (RR 0.14; 95% CI: 0.07-0.27) was a significant independent risk factor for reducing HRA using a multivariate analysis model. Longer duration of caffeine therapy after discharge (RR 1.05; 95% CI: 1.04-1.04), those who were born in multiple births (RR 1.15; 95% CI: 1.15-1.15), and those who had higher number of siblings were other significant independent risk factors for HRA. PCC dispensation in the appropriate dosage form at discharge effectively reduced cost, non-adherence to therapy, and risk of hospital readmissions. This neonatal clinical and compounding pharmacist-led model can be replicated in other resource-limiting setting.</abstract><cop>San Francisco</cop><pub>Public Library of Science</pub><pmid>36350877</pmid><doi>10.1371/journal.pone.0275655</doi><tpages>e0275655</tpages><orcidid>https://orcid.org/0000-0003-2728-6726</orcidid><orcidid>https://orcid.org/0000-0002-6287-6898</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 1932-6203
ispartof PloS one, 2022-11, Vol.17 (11), p.e0275655-e0275655
issn 1932-6203
1932-6203
language eng
recordid cdi_plos_journals_2734593548
source PMC (PubMed Central); Publicly Available Content (ProQuest)
subjects Apnea
Apnea neonatorum
Biology and Life Sciences
Caffeine
Care and treatment
Diagnosis
Dosage
Drug dosages
Drugs
Evaluation
Extubation
Gestational age
Health aspects
Health risks
Infants (Premature)
Medication adherence
Medicine and Health Sciences
Multiple births
Multivariate analysis
Neonates
Newborn babies
Patient compliance
Pediatrics
People and Places
Pharmacists
Physical Sciences
Quality control
Quasi-experimental methods
Risk analysis
Risk factors
Services
Socioeconomic factors
Tertiary
Therapy
Ventilators
title Evaluation of pharmaceutically compounded oral caffeine on the impact of medication adherence and risk of readmission among preterm neonates: A single-center quasi-experimental study
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-31T18%3A13%3A02IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Evaluation%20of%20pharmaceutically%20compounded%20oral%20caffeine%20on%20the%20impact%20of%20medication%20adherence%20and%20risk%20of%20readmission%20among%20preterm%20neonates:%20A%20single-center%20quasi-experimental%20study&rft.jtitle=PloS%20one&rft.au=Ambreen,%20Gul&rft.date=2022-11-09&rft.volume=17&rft.issue=11&rft.spage=e0275655&rft.epage=e0275655&rft.pages=e0275655-e0275655&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0275655&rft_dat=%3Cgale_plos_%3EA725966565%3C/gale_plos_%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c603t-da80ea8dd760c79d752a4530ce1218388f575ec0b8366efb5a90325d7ce402d53%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2734593548&rft_id=info:pmid/36350877&rft_galeid=A725966565&rfr_iscdi=true