PedDrugDose is a Windows (95 & greater) application for
health care professional dose oral liquid pediatric medications.
While at first glance this may seem like a relatively straightforward
task, there are a number of mistakes which are often made. Medication
dosing errors are entirely too common and as medical care "evolves" in
this country, we are forced to spend less and less time with our
patients. Since correctly calculating a dose takes time,
shortcuts are often made, sometimes with devastating results.
There have been a number of studies documenting
the unacceptable high incidence of outpatient pediatric dosing errors -
I have included a few on the main page to highlight this problem.
While a medical student, and later as a
resident, I was able to experience the scope of this problem firsthand.
We were taught the correct way to dose pediatric medications, but most
practitioners would still use some guesswork or approximations and the
reason given was always the time it takes to do it correctly.
Very often this justification would be followed by something like "and
I've been doing it for long enough to know..." I performed my own
informal review of prescriptions written during two years of my
training by students, residents and attendings at the various
facilities I rotated through. This involved looking at the
records or prescription copies and running the calculations. What
I found was a surprisingly high error rate of about 40% (including
minor errors) which was slightly higher than the
published dosing error rates which vary
between 5% and 31%1,2. As a
medical student, seeing
that it took me more time to calculate a pediatric prescription dose
(and I'm good at math!), I asked residents and attendings what they did
to speed this up and both freely admitted to relying on experience with
the medications and being able to estimate a dose for a child of this
or that size. A medical student has that luxury of time to go through
the calculations, but the
residents and attendings do not (though if you look here3,
manually doing the calculations doesn't help enough!). It is not,
however, a "luxury" -
patient safety demands that estimations and guesswork are removed from
the process. It was therefore both the time required and an unearned
confidence in the prescriber's own ability to estimate which seemed to
be the usual causes for the errors.
Firmly convinced that there had to be a better
way, I searched around for a program which would calculate the doses of
a variety of medications, give multiple dosing regimens, know the
dosing ranges and other parameters but allow me to change them and be
user friendly, as recommended
by the ISMP in 1998. I found no such program and so I decided
my own. PedDrugDose was first written in 2004 and was adopted by
my residency program in 2005 just before I finished. My partners
and I use it daily where I currently practice, Skyline Family Practice,
in Front Royal, VA. I recently decided to turn this program into
a commercial product, thus this web site.
My goal is to eliminate preventable pediatric
medication dosing errors. Please, if you have suggestions,
feature requests, ideas for improvement, etc., do not hesitate to send
them to me via email.