Skip to main content
Top
Published in: Drugs - Real World Outcomes 4/2015

Open Access 01-12-2015 | Original Research Article

Drug Utilisation Patterns in Children Admitted to a Paediatric General Medical Ward in Five Countries

Authors: Asia N. Rashed, Ian C. K. Wong, Lynda Wilton, Stephen Tomlin, Antje Neubert

Published in: Drugs - Real World Outcomes | Issue 4/2015

Login to get access

Abstract

Objective

To investigate and compare drug prescription patterns in children admitted to a paediatric general medical ward in five countries.

Methods

A prospective cohort study conducted on paediatric medical wards in the UK, Germany, Australia, Hong Kong (HK) and Malaysia. Data were collected over 3 months in each country except in Australia (1 month). All medications prescribed were classified according to the WHO Anatomical Therapeutic Chemical (ATC) classification. For each drug, frequency of prescriptions and patient exposures were calculated for ATC anatomical and therapeutic levels overall and by country.

Results

One thousand two hundred and seventy-eight patients were included (Australia 146, Germany 376, UK 313, HK 143 and Malaysia 300); 89.2 % of patients (1140) received medications, median 3 (interquartile range 2–5) drugs per patient. 5367 drugs were prescribed. The most frequently prescribed therapeutic groups in all countries were: systemic antibacterials (1355; 25.2 %), analgesics/non-steroidal anti-inflammatory drugs (NSAIDs) (1173; 21.8 %) and drugs for obstructive airway diseases (472; 8.8 %). Overall, 65.1 % (742) of patients received at least one systemic antibacterial, 63.7 % (726) received one or more analgesic/NSAIDs, and 23.6 % (269) received ‘drugs for obstructive airway diseases’. The number of patients exposed to these groups differed significantly between countries (p < 0.05). Paracetamol was the most frequently prescribed in all countries, but metamizole was only used in Germany. Morphine was mainly prescribed in the UK.

Conclusion

This study provides an overview of drug use patterns in five culturally and ethnically diverse countries. The most frequently used therapeutic groups were similar, but the proportion of patients treated differed between countries. Also within a therapeutic group the specific drug used varied between countries.
Literature
3.
go back to reference Porta A, Hsia Y, Doerholt K, et al. Comparing neonatal and paediatric antibiotic prescribing between hospitals: a new algorithm to help international benchmarking. J Antimicrob Chemother. 2012;67:1278–86.CrossRefPubMed Porta A, Hsia Y, Doerholt K, et al. Comparing neonatal and paediatric antibiotic prescribing between hospitals: a new algorithm to help international benchmarking. J Antimicrob Chemother. 2012;67:1278–86.CrossRefPubMed
4.
go back to reference Neubert A, Hsia Y, de Jong-van den Berg LT, et al. Comparison of anti-diabetic drug prescribing in children and adolescents in seven European countries. Br J Clin Pharmacol. 2011;72:969–77.PubMedCentralCrossRefPubMed Neubert A, Hsia Y, de Jong-van den Berg LT, et al. Comparison of anti-diabetic drug prescribing in children and adolescents in seven European countries. Br J Clin Pharmacol. 2011;72:969–77.PubMedCentralCrossRefPubMed
5.
go back to reference Rani F, Murray M, Byrne P, et al. Epidemiologic features of antipsychotic prescribing to children and adolescents in primary care in the United Kingdom. Pediatrics. 2008;121:1002–9.CrossRefPubMed Rani F, Murray M, Byrne P, et al. Epidemiologic features of antipsychotic prescribing to children and adolescents in primary care in the United Kingdom. Pediatrics. 2008;121:1002–9.CrossRefPubMed
6.
go back to reference Ackers R, Murray ML, Besag FMC, et al. Prioritising Children’s medicines for research: A pharmacoepidemiological study on antiepileptic drugs. Br J Clin Pharmacol. 2007;63:689–97.PubMedCentralCrossRefPubMed Ackers R, Murray ML, Besag FMC, et al. Prioritising Children’s medicines for research: A pharmacoepidemiological study on antiepileptic drugs. Br J Clin Pharmacol. 2007;63:689–97.PubMedCentralCrossRefPubMed
7.
go back to reference Murray ML, de Vries CS, Wong ICK. A drug utilisation study of antidepressants in children and adolescents using the General Practice Research Database. Arch Dis Child. 2004;89:1098–102.PubMedCentralCrossRefPubMed Murray ML, de Vries CS, Wong ICK. A drug utilisation study of antidepressants in children and adolescents using the General Practice Research Database. Arch Dis Child. 2004;89:1098–102.PubMedCentralCrossRefPubMed
8.
go back to reference Neubert A, Sturkenboom MC, Murray ML, et al. Databases for pediatric medicine research in European-assessment and critical appraisal. Pharmacoepidemiol Drug Saf. 2008;17:1155–67.CrossRefPubMed Neubert A, Sturkenboom MC, Murray ML, et al. Databases for pediatric medicine research in European-assessment and critical appraisal. Pharmacoepidemiol Drug Saf. 2008;17:1155–67.CrossRefPubMed
9.
go back to reference Star K, Caster O, Bate A, et al. Dose variations associated with formulations of NSAID prescriptions for children: a descriptive analysis of electronic health records in the UK. Drug Saf. 2011;34:307–17.CrossRefPubMed Star K, Caster O, Bate A, et al. Dose variations associated with formulations of NSAID prescriptions for children: a descriptive analysis of electronic health records in the UK. Drug Saf. 2011;34:307–17.CrossRefPubMed
11.
go back to reference Abi Khaled L, Ahmad F, Brogan T, et al. Prescription medicine use by one million Canadian children. Paediatr Child Health. 2003;8(Suppl A):6A–56A. Abi Khaled L, Ahmad F, Brogan T, et al. Prescription medicine use by one million Canadian children. Paediatr Child Health. 2003;8(Suppl A):6A–56A.
12.
go back to reference Warrier I, Du W, Natarajan G, et al. Patterns of drug utilization in a neonatal intensive care unit. J Clin Pharmacol. 2006;46:449–55.CrossRefPubMed Warrier I, Du W, Natarajan G, et al. Patterns of drug utilization in a neonatal intensive care unit. J Clin Pharmacol. 2006;46:449–55.CrossRefPubMed
13.
go back to reference Pandolfini C, Kaguelidou F, Sequi M, et al. Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections. Eur J Clin Pharmacol. 2013;69:1031–6.PubMedCentralCrossRefPubMed Pandolfini C, Kaguelidou F, Sequi M, et al. Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections. Eur J Clin Pharmacol. 2013;69:1031–6.PubMedCentralCrossRefPubMed
14.
go back to reference Cazzato T, Pandolfini C, Campi R, et al. Drug prescribing in out-patient children in Southern Italy. Eur J Clin Pharmacol. 2001;57:611–6.CrossRefPubMed Cazzato T, Pandolfini C, Campi R, et al. Drug prescribing in out-patient children in Southern Italy. Eur J Clin Pharmacol. 2001;57:611–6.CrossRefPubMed
15.
go back to reference Neubert A, Lukas K, Leis T, et al. Drug utilisation on a preterm and neonatal intensive care unit in Germany: a prospective, cohort-based analysis. Eur J Clin Pharmacol. 2010;66:87–95.CrossRefPubMed Neubert A, Lukas K, Leis T, et al. Drug utilisation on a preterm and neonatal intensive care unit in Germany: a prospective, cohort-based analysis. Eur J Clin Pharmacol. 2010;66:87–95.CrossRefPubMed
16.
go back to reference Rashed AN, Wong IC, Cranswick N, et al. Adverse drug reactions in children – international surveillance and evaluation (ADVISE): a multicentre cohort study. Drug Saf. 2012;35:481–94.CrossRefPubMed Rashed AN, Wong IC, Cranswick N, et al. Adverse drug reactions in children – international surveillance and evaluation (ADVISE): a multicentre cohort study. Drug Saf. 2012;35:481–94.CrossRefPubMed
22.
go back to reference Jannin V, Lemagnen G, Gueroult P, et al. Rectal route in the 21st century to treat children. Adv Drug Deliv Rev. 2014;73:34–49.CrossRefPubMed Jannin V, Lemagnen G, Gueroult P, et al. Rectal route in the 21st century to treat children. Adv Drug Deliv Rev. 2014;73:34–49.CrossRefPubMed
23.
go back to reference van Houten MA, Luinge K, Laseur M, et al. Antibiotic utilisation for hospitalised paediatric pateitns. Int J Antimicob Agents. 1998;10:161–4.CrossRef van Houten MA, Luinge K, Laseur M, et al. Antibiotic utilisation for hospitalised paediatric pateitns. Int J Antimicob Agents. 1998;10:161–4.CrossRef
24.
go back to reference Fossum GH, Lindbaek M, Gjelstad S, et al. Are children carrying the burden of broad-spectrum antibiotics in general practice? Prescription pattern for paediatric outpatients with respiratory tract infections in Norway. BMJ Open. 2013;3:e002285.PubMedCentralCrossRefPubMed Fossum GH, Lindbaek M, Gjelstad S, et al. Are children carrying the burden of broad-spectrum antibiotics in general practice? Prescription pattern for paediatric outpatients with respiratory tract infections in Norway. BMJ Open. 2013;3:e002285.PubMedCentralCrossRefPubMed
25.
go back to reference Rashed AN, Wong IC, Cranswick N, et al. Risk factors associated with adverse drug reactions in hospitalised children: international multicentre study. Eur J Clin Pharmacol. 2012;68:801–10.CrossRefPubMed Rashed AN, Wong IC, Cranswick N, et al. Risk factors associated with adverse drug reactions in hospitalised children: international multicentre study. Eur J Clin Pharmacol. 2012;68:801–10.CrossRefPubMed
26.
go back to reference Neubert A, Verhamme K, Murray ML, et al. The prescribing of analgesics and non-steroidal anti-inflammatory drugs in paediatric primary care in the UK, Italy and the Netherlands. Pharmacol Res. 2010;62:243–8.CrossRefPubMed Neubert A, Verhamme K, Murray ML, et al. The prescribing of analgesics and non-steroidal anti-inflammatory drugs in paediatric primary care in the UK, Italy and the Netherlands. Pharmacol Res. 2010;62:243–8.CrossRefPubMed
27.
go back to reference O’Donnell CP, Stone RJ, Morely CJ. Unlicensed and off-label drug use in an Australian neonatal intensive care unit. Pediatrics. 2002;110:e52.CrossRefPubMed O’Donnell CP, Stone RJ, Morely CJ. Unlicensed and off-label drug use in an Australian neonatal intensive care unit. Pediatrics. 2002;110:e52.CrossRefPubMed
28.
go back to reference Lasky T, Ernst FR, Greenspan J, et al. Estimating pediatric inpatient medication use in the United States. Pharmacoepidemiol Drug Saf. 2011;20:76–82.CrossRefPubMed Lasky T, Ernst FR, Greenspan J, et al. Estimating pediatric inpatient medication use in the United States. Pharmacoepidemiol Drug Saf. 2011;20:76–82.CrossRefPubMed
29.
go back to reference Lasky T, Greenspan J, Ernst FR, et al. Morphine use in hospitalized children in the United States: a descriptive analysis of data from pediatric hospitalizations in 2008. Clin Ther. 2012;34:720–7.CrossRefPubMed Lasky T, Greenspan J, Ernst FR, et al. Morphine use in hospitalized children in the United States: a descriptive analysis of data from pediatric hospitalizations in 2008. Clin Ther. 2012;34:720–7.CrossRefPubMed
30.
go back to reference Hedenmalm K, Spigset O. Agranulocytosis and other blood dyscrasias associated with dipyrone (metamizole). Eur J Clin Pharmacol. 2002;58:265–74.CrossRefPubMed Hedenmalm K, Spigset O. Agranulocytosis and other blood dyscrasias associated with dipyrone (metamizole). Eur J Clin Pharmacol. 2002;58:265–74.CrossRefPubMed
31.
go back to reference Gozzoli V, Treqqiari MM, Kleger GR, et al. Randomized trial of the effect of antipyresis by metamizol, propacetamol or external cooling on metabolism, hemodynamics and inflammatory response. Intensive Care Med. 2004;30:401–7.CrossRefPubMed Gozzoli V, Treqqiari MM, Kleger GR, et al. Randomized trial of the effect of antipyresis by metamizol, propacetamol or external cooling on metabolism, hemodynamics and inflammatory response. Intensive Care Med. 2004;30:401–7.CrossRefPubMed
32.
go back to reference Oehme AK, Rashed AN, Hefele B, et al. Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison. PLoS One. 2012;7:e44349.PubMedCentralCrossRefPubMed Oehme AK, Rashed AN, Hefele B, et al. Adverse drug reactions in hospitalised children in Germany are decreasing: results of a nine year cohort-based comparison. PLoS One. 2012;7:e44349.PubMedCentralCrossRefPubMed
33.
go back to reference Jankovió SM, Đukić-Dejanović SM. Drug utilization trends in clinical hospital center “KRAGUJEVAC” from 1997 to 1999. Indian J Pharmcol. 2001;33:29–36. Jankovió SM, Đukić-Dejanović SM. Drug utilization trends in clinical hospital center “KRAGUJEVAC” from 1997 to 1999. Indian J Pharmcol. 2001;33:29–36.
34.
go back to reference Clavenna A, Sequi M, Bortolotti A, et al. Determinants of the drug utilization profile in the paediatric population in Italy’s Lombardy Region. Br J Clin Pharmacol. 2009;67:565–71.PubMedCentralCrossRefPubMed Clavenna A, Sequi M, Bortolotti A, et al. Determinants of the drug utilization profile in the paediatric population in Italy’s Lombardy Region. Br J Clin Pharmacol. 2009;67:565–71.PubMedCentralCrossRefPubMed
35.
go back to reference Solomon P. Congruence between health professionals’ and patients’ pain ratings: a review of the literature. Scand J Caring Sci. 2001;15:174–80.CrossRefPubMed Solomon P. Congruence between health professionals’ and patients’ pain ratings: a review of the literature. Scand J Caring Sci. 2001;15:174–80.CrossRefPubMed
36.
go back to reference Khor CS, Sam IC, Hooi PS, Quek KF, Chan YF. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years. BMC Pediatr. 2012;12:32.PubMedCentralCrossRefPubMed Khor CS, Sam IC, Hooi PS, Quek KF, Chan YF. Epidemiology and seasonality of respiratory viral infections in hospitalized children in Kuala Lumpur, Malaysia: a retrospective study of 27 years. BMC Pediatr. 2012;12:32.PubMedCentralCrossRefPubMed
Metadata
Title
Drug Utilisation Patterns in Children Admitted to a Paediatric General Medical Ward in Five Countries
Authors
Asia N. Rashed
Ian C. K. Wong
Lynda Wilton
Stephen Tomlin
Antje Neubert
Publication date
01-12-2015
Publisher
Springer International Publishing
Published in
Drugs - Real World Outcomes / Issue 4/2015
Print ISSN: 2199-1154
Electronic ISSN: 2198-9788
DOI
https://doi.org/10.1007/s40801-015-0049-y

Other articles of this Issue 4/2015

Drugs - Real World Outcomes 4/2015 Go to the issue

Acknowledgement to Referees

Acknowledgments