Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia

Nurul Fadilah Mohamad, Adliah Mhd Ali, Noraida Mohamed Shah

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world. Objectives To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia. Setting Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia. Methods The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011. Main outcome measure Characteristics of the off-label respiratory drug prescriptions were measured. Results A total of 134 children (60.9 %) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 %), followed by higher than the recommended dose (24.9 %) and lower than the recommended frequency (17.1 %). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4–6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1–3 medications (OR 7.8, 95 % CI 1.74–37.44). Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.

Original languageEnglish
Pages (from-to)127-132
Number of pages6
JournalInternational Journal of Clinical Pharmacy
Volume37
Issue number1
DOIs
Publication statusPublished - 2014

Fingerprint

Hospital Outpatient Clinics
Malaysia
Labels
Drug Prescriptions
Pediatrics
Pharmaceutical Preparations
Off-Label Use
Ambulatory Care Facilities
Diphenhydramine
Prescription Drugs
Computer Systems
Tertiary Care Centers
Teaching Hospitals
Medical Records
Outcome Assessment (Health Care)
Medicine
Teaching
Research
Computer systems
Population

Keywords

  • Children
  • Malaysia
  • Off-label
  • Outpatient
  • Pediatrics
  • Respiratory drugs

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmaceutical Science
  • Pharmacology
  • Toxicology
  • Pharmacy

Cite this

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title = "Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia",
abstract = "Background Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world. Objectives To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia. Setting Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia. Methods The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011. Main outcome measure Characteristics of the off-label respiratory drug prescriptions were measured. Results A total of 134 children (60.9 {\%}) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 {\%}), followed by higher than the recommended dose (24.9 {\%}) and lower than the recommended frequency (17.1 {\%}). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4–6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1–3 medications (OR 7.8, 95 {\%} CI 1.74–37.44). Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.",
keywords = "Children, Malaysia, Off-label, Outpatient, Pediatrics, Respiratory drugs",
author = "Mohamad, {Nurul Fadilah} and {Mhd Ali}, Adliah and {Mohamed Shah}, Noraida",
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T1 - Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia

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AU - Mhd Ali, Adliah

AU - Mohamed Shah, Noraida

PY - 2014

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N2 - Background Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world. Objectives To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia. Setting Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia. Methods The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011. Main outcome measure Characteristics of the off-label respiratory drug prescriptions were measured. Results A total of 134 children (60.9 %) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 %), followed by higher than the recommended dose (24.9 %) and lower than the recommended frequency (17.1 %). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4–6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1–3 medications (OR 7.8, 95 % CI 1.74–37.44). Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.

AB - Background Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world. Objectives To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia. Setting Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia. Methods The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011. Main outcome measure Characteristics of the off-label respiratory drug prescriptions were measured. Results A total of 134 children (60.9 %) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 %), followed by higher than the recommended dose (24.9 %) and lower than the recommended frequency (17.1 %). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4–6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1–3 medications (OR 7.8, 95 % CI 1.74–37.44). Conclusion There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.

KW - Children

KW - Malaysia

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KW - Pediatrics

KW - Respiratory drugs

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