Neocheck: A Prescription-Screening Tool To Optimise Pharmacotherapy For Hospitalised Neonates

AIMS OF THE STUDY: To develop a screening tool to optimiseneonatal drug prescription, which is often based onlow-quality evidence.METHODS: Neonatal pharmacotherapy recommendations were identified by literature review and synthesised into NeoCheck tool statements. In a two-round modified Delphi process, experts from Swiss neonatal intensivecare units (NICUs) rated their agreement with individual statements using a five-point Likert scale (5 = totallyagree). Statements with >65% scores >= 4 in round 1 and >75% scores >= 4 in round 2 were selected.RESULTS: We identified 1375 clinical guidelines via literaturereview. After synthesis, 158 statements were submittedto 23 experts (1 clinical pharmacist, 22 neonatologists;65% with >10 years neonatology practice) from 10 Swiss NICUs. Nineteen items did not reach the agreementthreshold and were eliminated in the second Delphiround. The final NeoCheck tool comprises 141 statementsin 11 medical domains concerning 49 neonatal diseases.Most (79%) statements concern all neonates, 13% concernpreterm (<37 weeks gestational age) infants and 3%concern very preterm (<32 weeks gestational age) infantsCONCLUSIONS: NeoCheck is the first prescription-screening tool developed to optimise neonatal pharmacotherapy.In a future prospective study, its effect on NICU prescription optimisation and the quality of care will be assessed.