NP-013 The neocheck project: development of a prescription-screening tool specific to neonatology

Background and importanceNeonatal pharmacotherapy is challenging and often based on little evidence. Off label use of drugs is common practice and patients are at a high risk of medication errors and drug-related problems. Prescription-screening tools are used in geriatrics, internal medicine and pediatrics to optimize drug prescribing.Aim and objectivesOur aim was to develop a prescription-screening tool specific to neonatology.Materials and methodsClinical guidelines on neonatal pharmacotherapy were identified by a literature review and synthetized into short statements. A 2-rounds Delphi consensus method was used to establish the content validity of Neocheck. The statements were submitted to a group of 23 experts in 10 Swiss neonatology centers. The level of agreement was evaluated on a 5-point Likert scale (1 being the highest level of agreement). Statements for which >65% of experts gave the statement a rating of 1 or 2 were selected at round 1. This cut off was raised to >75% at round two.ResultsA total of 1375 clinical guidelines were identified from the literature search. After synthesis, 158 statements were submitted to the group of 23 Swiss experts. The mean agreement rating was 1.62 (95% CI 1.55 to 1.70) during the 1st round of Delphi and 1.32 (95% CI 1.28 to 1.37) during the 2nd round. The final Neocheck tool is composed of 141 statements on 11 medical domains and 49 neonatal diseases. On average, 95% (95% CI 94%-96%) of experts either totally agreed or slightly agreed with the validated statements.Conclusion and relevanceA prescription-screening tool specific to neonatalogy was developed and validated by a group of 23 Swiss experts. The impact of Neocheck on the optimization of drug use in neonates and its potential interest as a teaching tool for young physicians and clinical pharmacists need to be evaluated in the future.