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01-10-2018 | Original Article

A survey of medicine use in children and adolescents in Austria

Authors: Elisabeth Rauch, Florian B. Lagler, Harald Herkner, Walter Gall, Robert Sauermann, Silvia Hetz, Christoph Male

Published in: European Journal of Pediatrics | Issue 10/2018

Abstract

Aims of this survey were to evaluate prescription patterns for children and adolescents in primary and hospital care settings in Austria and to identify the medicines used most frequently in this population. Prescription data were assessed for the year 2014: for primary care, reimbursement data were obtained from Austrian health insurances; for hospital care, information on medicines dispensed to pediatric wards from hospital pharmacies. Frequencies of medicine use were analyzed by Anatomical Therapeutic Chemical classification system, age groups, and care setting. In primary care, anti-infectives (25%) and medicines for the respiratory system (14%) and for the nervous system (13%); in hospitals, anti-infectives (23%) and medicines for the nervous system (13%) and alimentary tract (12%) were prescribed most frequently. Amoxicillin/beta-lactamase inhibitor, ibuprofen, and paracetamol were the most frequent substances in both primary and hospital care settings. Based on the top 80% prescribed substances, a hit list of 150 pediatric medicines was defined for Austria.

Conclusion: This is the first representative and comprehensive survey of medicine use in children and adolescents in Austria, allowing comparison of prescription patterns to other European countries and assessing temporal trends in the future. Moreover, it serves as basis for planned measures to improve rational use of pediatric medicines.

What is Known: • Large knowledge gaps exist for medicine use in children and adolescents concerning appropriate dosing, efficacy, and safety aspects. • Off-label medicine use is common in the treatment of children and adolescents.
What is New: • We present a comprehensive survey of current prescription patterns for children and adolescents in Austria and define a hit list of pediatric medicines, as basis for developing an evidence-based information platform for health care professionals. • Anti-infectives, medicines for respiratory tract system, and pain medication are most frequently prescribed.

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Bonati M, Pandolfini C (2011) Off-label drug use in children should be rational. Arch Dis Child 96(9):870–871CrossRefPubMed

Bonati M, Jacqz-Aigrain E, Choonara I (2017) Licensed medicines, off-label use or evidence-based. Which is most important? Arch Dis Child 102(1):53–54CrossRefPubMed

Cardile S, Martinelli M, Barabino A, Gandullia P, Oliva S, di Nardo G, Dall'Oglio L, Rea F, de'Angelis GL, Bizzarri B, Guariso G, Masci E, Staiano A, Miele E, Romano C (2016) Italian survey on non-steroidal anti-inflammatory drugs and gastrointestinal bleeding in children. World J Gastroenterol 22(5):1877–1883CrossRefPubMedPubMedCentral

Cazzato T, Pandolfini C, Campi R, Bonati M, ACP Puglia-Basilicata Working Group (2001) Drug prescribing in out-patient children in Southern Italy. Eur J Clin Pharmacol 57(8):611–616CrossRefPubMed

Clavenna A, Bonati M (2009) Drug prescriptions to outpatient children: a review of the literature. Eur J Clin Pharm 65:749–755CrossRef

Czarniak P, Bint L, Favié L, Parsons R, Hughes J, Sunderland B (2015) Clinical setting influences off-label and unlicensed prescribing in a paediatric teaching hospital. PLoS One 10(3):e0120630CrossRefPubMedPubMedCentral

De Martino M, Chiarugi A (2015) Recent advances in pediatric use of oral paracetamol in fever and pain management. Pain Ther 4:149–168CrossRefPubMedPubMedCentral

Di Paolo E, Stoetter H, Cotting J, Frey P, Gehri M, Beck-Popovic M, Tolsa JF, Fanconi S, Pannatier A (2006) Unlicensed and off-label drug use in a Swiss paediatric university hospital. Swiss Med Wkly 136:218–222PubMed

Dills R, Anderson LA, Pierce CA (2012) The role of nonsteroidal anti-inflammatory drugs in pediatric patients. Pharmacol Res 65(1):5–8CrossRefPubMed

10.

European Commission (2006) Regulation (EC) No1901/2006 and 1902/2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use. Official J Eur Communities, 18: L378/1 and L/20

11.

Holstiege J, Enders D, Schink T, Innocenti F, Oteri A, Bezemer I, Kaguelidou F, Molokhia M, Poluzzi E, Puccini A, Ulrichsen SP, Sturkenboom MC, Trifiro G, Garbe E (2015) Trends in paediatric macrolide use in five European countries—a population based study. Eur J Clin Pharmacol 71:991–999CrossRefPubMed

12.

Horen B, Montastruc JL, Lapeyre-Mestre M (2002) Adverse drug reactions and off-label drug use in paediatric outpatients. Br J Clin Pharmacol 54(6):665–670CrossRefPubMedPubMedCentral

13.

Hsu B, Brazelton T (2009) Off-label medication use in an academic hospital pediatric critical care unit. WMJ 108(7):343–348PubMed

14.

Janett S, Camozzi P, Peeters G, Lava S, Simonetti G, Simonetti B, Bianchetti M, Milani G (2015) Hypomagnesemia induced by long-term treatment with proton-pump inhibitors. Gastroenterol Res Pract 951768

15.

Kazouini A, Mohammed BS, Simpson CR, Helms PJ, McLay JS (2011) Paracetamol prescribing in primary care: too little and too much? Br J Clin Pharmacol 72(3):500–504CrossRefPubMedPubMedCentral

16.

Lasky T, Ernst FR, Greenspan J, Wang S, Gonzalez L (2011) Estimating pediatric inpatient medication use in the United States. Pharmacoepidemiol Drug Saf 20(1):76–82CrossRefPubMed

17.

Lass J, Irs A, Pisarev H, Leinemann T, Lutsar I (2011) Off label use of prescription medicines in children in outpatient setting in Estonia is common. Pharmacoepidemiol Drug Saf 20(5):474–481CrossRefPubMed

18.

Lindell-Osuagwu L, Korhonen MJ, Saano S, Helin-Tanninen M, Naaranlahti T, Kokki H (2009) Off-label and unlicensed drug prescribing in three paediatric wards in Finland and review of the international literature. J Clin Pharm Ther 34(3):277–287CrossRefPubMed

19.

Mason J, Pirmohamed M, Nunn T (2012) Off-label and unlicensed medicine use and adverse drug reactions in children: a narrative review of the literature. Eur J Clin Pharmacol 68:21–28CrossRefPubMed

20.

Neubert A, Dormann H, Weiss J, Egger T, Criegee-Rieck M, Rascher W, Brune K, Hinz B (2004) The impact of unlicensed and off-label drug use on adverse drug reactions in paediatric patients. Drug Saf 27(13):1059–1067CrossRefPubMed

21.

Olsson J, Kimland E, Pettersson S, Odlind V (2011) Paediatric drug use with focus on off-label prescriptions in Swedish outpatient care—a nationwide study. Acta Paediatr 100(9):1272–1275CrossRefPubMedPubMedCentral

22.

Palmaro A, Bissuel R, Renaud N, Durrieu G, Escourrou B, Oustric S, Montastruc JL, Lapeyre-Mestre M (2015) Off-label prescribing in pediatric outpatients. Pediatrics 135(1):49–58CrossRefPubMed

23.

Pharmaceutical Press (2016) British National Formulary for Children

24.

Rashed AN, Wong IC, Wilton L, Tomlin S, Neubert A (2015) Drug utilisation patterns in children admitted to a paediatric general medical ward in five countries. Drugs Real World Outcomes 2(4):397–410CrossRefPubMedPubMedCentral

25.

Sturkenboom MC, Verhamme KM, Nicolosi A et al (2008) Drug use in children: cohort study in three European countries. BMJ 337:a2245. https://doi.org/10.1136/bmj.a2245 CrossRefPubMedPubMedCentral

26.

Sullivan JE, Farrar HC (2011) Fever and antipyretic use in children. Pediatrics 127:580–587CrossRefPubMed

27.

US Food and Drug Administration (2007) Pediatric Research Equity Act (PREA) and Best Pharmaceuticals for Children Act (BPCA) 2007 http://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/DevelopmentResources/UCM049870.pdf (accessed 2017-09)

28.

Van der Zanden TM, de Wildt SN, Liem Y, Offringa M, de Hoog M et al (2017) Developing a paediatric drug formulary for the Netherlands. Arch Dis Child 102(4):357–361. https://doi.org/10.1136/archdischild-2016-311674 CrossRefPubMed

Title: A survey of medicine use in children and adolescents in Austria
Authors: Elisabeth Rauch
Florian B. Lagler
Harald Herkner
Walter Gall
Robert Sauermann
Silvia Hetz
Christoph Male
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Pediatrics / Issue 10/2018
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-018-3196-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

A survey of medicine use in children and adolescents in Austria

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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