Abstract
BackgroundThe appropriate use of medications is essential in children. Yet, detailed information on how drugs are being prescribed and dispensed to pediatric populations is not documented in China.AimThe study objective was to analyze the details of medicine use and categorize the types of inappropriate use of medications on children.MethodsA retrospective cross-sectional study was conducted on the prescriptions of pediatric outpatients aged < 18 years from 2019 to 2020 at a major Chinese tertiary academic center. Each age group’s demographic and clinical characteristics were collected, and the ratios of inappropriate prescriptions were analyzed.ResultsThe total number of pediatric outpatients was 652,152, and 49.37% (322000) were prescribed medications, in which the most widely used medicines were respiratory, anti-infectives, and Traditional Chinese Medicines (TCMs). The prevalence rate of inappropriate prescriptions reached 20.49%, and in 2019 it was higher (21.71%) than that in 2020 (18.36%). The top three common inappropriate categories were indication-related off-label drug use, improper administration frequency, and overdosing, accounting for 67.93, 17.80 and 11.06% of all inappropriate prescriptions, respectively. The inappropriate prescriptions were more likely seen in patients aged 2–5 years and respiratory medicines.ConclusionsThe study findings indicate that inappropriate drug use in pediatric outpatients is still common, and great attention needs to be paid. More prospective trials are required to identify the effectiveness, safety, and necessity of off-label drug use of medicines in children.
Highlights
Data from the sixth national census shows that the population in the age range of 0–14 years reached 253 million, accounting for 17.95% of the total population in 2020 in China [1]
Data sources The prescriptions of pediatric outpatients aged < 18 years prescribed during January 1, 2019 and December 31, 2020 were extracted from the Hospital Information System (HIS) and Clinical rational drug use monitoring system
The proportion of children who received medications (RR 0.814; 95%CI 0.810–0.819; p < 0.001), the average number of medications prescribed (p < 0.001), and the proportion of children who received injected formulations (RR 0.773; 95%CI 0.765–0.783; p < 0.001) decreased significantly in 2020 compared with 2019
Summary
A retrospective cross-sectional study was conducted on the prescriptions of pediatric outpatients aged < 18 years from 2019 to 2020 at a major Chinese tertiary academic center. Each age group’s demographic and clinical characteristics were collected, and the ratios of inappropriate prescriptions were analyzed
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