What causes prescribing errors in children? Scoping review

Richard L. Conn, Orla Kearney, Mary Tully, Michael D. Shields, Tim Dornan

Research output: Contribution to journalArticlepeer-review


i. Systematically assemble, analyse and synthesise published evidence on causes of prescribing error in children
ii. Present results to a multidisciplinary group of paediatric prescribing stakeholders to validate findings and establish how causative factors lead to errors in practice
Scoping review using Arksey and O’Malley framework, including stakeholder consultation; qualitative evidence synthesis
We followed the six scoping review stages.
(i) Research question - the research question was ‘What is known about causes of prescribing error in children.
(ii) Search strategy - we searched MEDLINE, EMBASE, CINAHL (inception to February 2018), grey literature, and reference lists of included studies.
(iii) Article selection - all published evidence contributing information on the causes of prescribing error in children was eligible for inclusion. We included review articles as secondary evidence to broaden understanding.
(iv) Charting data – results were collated in a custom data charting form
(v) Reporting results - we summarised article characteristics, extracted causal evidence, and thematically synthesised findings.
(vi) Stakeholder consultation - results were presented to a multidisciplinary focus group of six prescribing stakeholders to establish validity, relevance and mechanisms by which causes lead to errors in practice.
68 articles were included. We identified six main causes of prescribing errors. Children’s fundamental differences led to individualised dosing and calculations; off-license prescribing; medication formulations; communication with children; and experience working with children. Primary evidence clarifying causes was lacking.
Specific factors complicate prescribing for children and increase risk of errors. Primary research is needed to confirm and elaborate these causes of error. In the meantime, this review uses existing evidence to make provisional paediatric-specific recommendations for policy, practice and education.

Strengths and limitations of this study
• This study used systematic methods to provide a comprehensive review of causes of prescribing errors in children
• We consulted prescribing stakeholders to add key contextual information on how errors happen in practice
• Risk of overemphasising expert opinion was introduced by the decision to include secondary evidence
• Article selection was made potentially subjective because of the study’s inclusive approach, bringing together all evidence that could contribute information on causes of errors
Original languageEnglish
JournalBMJ Open
Early online date10 Aug 2019
Publication statusPublished - 2019


Dive into the research topics of 'What causes prescribing errors in children? Scoping review'. Together they form a unique fingerprint.

Cite this