The Impact of Pediatric Labeling Changes on Prescribing Patterns of Cough and Cold Medications

Abstract

To evaluate the impact of initiatives created by the pharmaceutical industry and the Food and Drug Administration to limit the use of over-the-counter (OTC) cough and cold medications (CCMs) in young children in emergency departments (EDs) and ambulatory clinics. Analysis of the National Hospital Ambulatory Medical Care Survey and National Ambulatory Medical Care Survey was performed comparing 2005-2006 and 2009-2010 in children aged ≤ 12 years with a reason for visit consistent with cough or cold-related symptoms. Data were stratified by age (<2 years, 2-6 years, and 6-12 years). Descriptive frequencies and survey-weighted χ(2) tests were used to assess OTC and prescription CCM prescription rates in ED and ambulatory clinic settings. Comparing 2005-2006 and 2009-2010 revealed no changes in ED use of OTC CCMs; however, the use of prescription CCMs decreased, from 6.7% to 2.9% (P = .001). In ambulatory clinics, the overall rate of OTC CCM use increased from 6.3% to 11.1% (P = .001); however, use by children aged <2 years was unchanged. Prescription CCM use in EDs declined in all age groups, but in ambulatory clinics, decreases were significant only in patients aged <2 years. Implementation of pharmaceutical industry and Food and Drug Administration initiatives did not decrease the use of OTC CCMs in children aged <2 years in EDs or ambulatory clinics. The use of prescription CCMs was decreased in both settings, however.