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Objectives This systematic review (SR) was undertaken to identify and summarise any factors which influence the implementation of paediatric clinical pharmacy service (CPS) from service users’ perspectives in hospital settings. Methods Literature search from EMBASE, MEDLINE, Web of Science (Core Collection), Cochrane Library, Scopus and CINAHL databases were performed in order to identify any relevant peer-reviewed quantitative and qualitative studies from inception until October 2019 by following the inclusion criteria. Boolean search operators were used which consisted of service, patient subgroup and attribute domains. Studies were screened independently and included studies were quality assessed using Mixed Methods Appraisal Tool. The study was reported against the ‘Enhancing Transparency in Reporting the Synthesis of Qualitative Research’ statement. Results 4199 citations were screened by title and abstract and 6 of 32 full publications screened were included. There were two studies that were graded as ‘high’ in quality, with four graded as ‘moderate’. The analysis has led to the identification of seven factors categorised in five predetermined overarching themes. These were: other healthcare professionals’ attitudes and acceptance; availability of clinical pharmacist on ward or outpatient settings; using drug-related knowledge to perform clinical activities; resources for service provision and coverage; involvement in a multidisciplinary team; training in the highly specialised areas and development of communication skills. Conclusion Evidence for paediatric CPS was sparse in comparison to a similar SR conducted in the adult population. An extensive knowledge gap within this area of practice has therefore been identified. Nevertheless, majority of the factors identified were viewed as facilitators which enabled a successful implementation of CPS in paediatrics. Further research is needed to identify more factors and exploration of these would be necessary in order to provide a strong foundation for strategic planning for paediatric CPS implementation and development.

Objectives This study aimed to evaluate the effect of a closed-loop computerised physician order entry (CPOE) system on prescribing in a general paediatric unit in Hong Kong. We studied the effect of the CPOE system on medication prescribing error and the characteristics of these errors before and after the implementation of the system. Methods This was a single-site, prospective, observational study at a public hospital’s general paediatric unit in Hong Kong, conducted during the pre- and post-implementation of the system from March to April 2019 and 2020, respectively. Collected data included the number of medication orders processed, the number of prescribing errors identified, and the characteristics of errors, such as the severity, children’s age group, drug formulation, and drug class. Key Findings The prescribing error rate was significantly reduced from 6.7% to 3.9% after CPOE implementation. The causes of prescribing errors were found to be significantly different, as the implementation eradicated handwriting-related errors and reduced dosage selection-related errors. However, we found that CPOE increased other causes of error, such as missing entry of patient information that might affect the dispensing process, thus delaying patients in receiving their medications on time. Conclusion The CPOE system significantly reduced prescribing errors and altered some of the characteristics of these errors. Poor system design or inadequate user training could result in the creation of new causes of error.

BACKGROUND To define the role of topical timolol maleate (TTM) in the treatment of infantile haemangiomata (IH). METHODS In this single-centre randomised controlled trial, we included all

Objectives To identify barriers and facilitators that influenced the implementation of paediatric clinical pharmacy service (CPS) in Hong Kong’s public hospitals from clinical pharmacists’ perspective. Methods A qualitative study based on semi-structured interviews of clinical pharmacists who practiced in paediatrics in public hospitals in Hong Kong. Interview schedule was designed based on determined themes identified in previous research and pilot testing was performed. The coding process was performed by two researchers with the resulting topics organised by thematic analysis. Consensus was reached amongst the researchers for the identification of themes that emerged during the interviews. The Consolidated Criteria for Reporting Qualitative Research guideline was followed to ensure the complete and transparent reporting of this research. Ethical approval for this study was obtained from the research ethics committee of the relevant institutions. Key findings Of the 32 clinical pharmacists from across the study sites, 12 were interviewed. Five barriers and three facilitators were identified as main themes. The barriers that were identified which hindered service implementation include the service penetration into the healthcare system, practice environment constraints, lack of affirmation from the administrative stakeholders, governance of the profession and partnership with universities. The facilitators that were identified which enabled service implementation include other healthcare professionals’ trust and confidence in the service, the support from the pharmacy management team and clinical pharmacists’ self-efficacy. Conclusions Clinical pharmacists interviewed reported that the successful implementation of CPS in paediatrics in public hospitals in Hong Kong is an area of continued development with several key barriers identified.