Literature DB >> 10625257

Survey of unlicensed and off label drug use in paediatric wards in European countries. European Network for Drug Investigation in Children.

S Conroy1, I Choonara, P Impicciatore, A Mohn, H Arnell, A Rane, C Knoeppel, H Seyberth, C Pandolfini, M P Raffaelli, F Rocchi, M Bonati, G Jong, M de Hoog, J van den Anker.   

Abstract

OBJECTIVE: To determine the extent of use of unlicensed and off label drugs in children in hospital in five European countries.
DESIGN: Prospective study of drugs administered to children in general paediatric medical wards over four weeks.
SETTING: Children's wards in five hospitals (one each in the United Kingdom, Sweden, Germany, Italy, and the Netherlands).
SUBJECTS: Children aged 4 days to 16 years admitted to general paediatric medical wards. MAIN OUTCOME MEASURE: Proportion of drugs that were used in an unlicensed or off label manner.
RESULTS: 2262 drug prescriptions were administered to 624 children in the five hospitals. Almost half of all drug prescriptions (1036; 46%) were either unlicensed or off label. Of these 1036, 872 were off label and 164 were unlicensed. Over half of the patients (421; 67%) received an unlicensed or off label drug prescription.
CONCLUSIONS: Use of off label or unlicensed drugs to treat children is widespread. This problem is likely to affect children throughout Europe and requires European action.

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Year:  2000        PMID: 10625257      PMCID: PMC27251          DOI: 10.1136/bmj.320.7227.79

Source DB:  PubMed          Journal:  BMJ        ISSN: 0959-8138


  10 in total

1.  Status of new medicines approved by the European Medicines Evaluation Agency regarding paediatric use.

Authors:  P Impicciatore; I Choonara
Journal:  Br J Clin Pharmacol       Date:  1999-07       Impact factor: 4.335

2.  Closing the gap in drug therapy.

Authors:  M Bonati; I Choonara; K Hoppu; G Pons; H Seyberth
Journal:  Lancet       Date:  1999-05-08       Impact factor: 79.321

3.  Unlicensed and off label drug use in neonates.

Authors:  S Conroy; J McIntyre; I Choonara
Journal:  Arch Dis Child Fetal Neonatal Ed       Date:  1999-03       Impact factor: 5.747

4.  Licensing of medicines.

Authors:  I Choonara; J Dunne
Journal:  Arch Dis Child       Date:  1998-05       Impact factor: 3.791

5.  Is the "therapeutic orphan" about to be adopted?

Authors:  C J Coté; R E Kauffman; G J Troendle; G H Lambert
Journal:  Pediatrics       Date:  1996-07       Impact factor: 7.124

6.  Unlicensed and off label drug use in paediatric wards: prospective study.

Authors:  S Turner; A Longworth; A J Nunn; I Choonara
Journal:  BMJ       Date:  1998-01-31

7.  Use of "off-label" and unlicensed drugs in paediatric intensive care unit.

Authors:  S Turner; A Gill; T Nunn; B Hewitt; I Choonara
Journal:  Lancet       Date:  1996-02-24       Impact factor: 79.321

8.  Adverse drug reactions to unlicensed and off-label drugs on paediatric wards: a prospective study.

Authors:  S Turner; A J Nunn; K Fielding; I Choonara
Journal:  Acta Paediatr       Date:  1999-09       Impact factor: 2.299

9.  Risks of agranulocytosis and aplastic anemia. A first report of their relation to drug use with special reference to analgesics. The International Agranulocytosis and Aplastic Anemia Study.

Authors: 
Journal:  JAMA       Date:  1986-10-03       Impact factor: 56.272

Review 10.  Epidemiologic evaluation of drug use in children.

Authors:  M Bonati
Journal:  J Clin Pharmacol       Date:  1994-04       Impact factor: 3.126

  10 in total
  191 in total

1.  A novel scheme for the reporting of adverse drug reactions.

Authors:  A Clarkson; E Ingleby; I Choonara; P Bryan; P Arlett
Journal:  Arch Dis Child       Date:  2001-04       Impact factor: 3.791

2.  Use of unlabelled and off licence drugs in children. Use of unlicensed drugs may be recommended in guidelines.

Authors:  F A Riordan
Journal:  BMJ       Date:  2000-04-29

3.  Unlicensed and off label prescribing of drugs in general practice.

Authors:  J McIntyre; S Conroy; A Avery; H Corns; I Choonara
Journal:  Arch Dis Child       Date:  2000-12       Impact factor: 3.791

4.  Clinical trials of medicines in children.

Authors:  I Choonara
Journal:  BMJ       Date:  2000-11-04

5.  Registering clinical trials. Register of clinical trials in children must be set up.

Authors:  M Bonati; P Impicciatore; C Pandolfini
Journal:  BMJ       Date:  2000-05-13

6.  An ABC of drug-related problems.

Authors:  R H Meyboom; M Lindquist; A C Egberts
Journal:  Drug Saf       Date:  2000-06       Impact factor: 5.606

7.  Prescribing of drugs for use outside their licence in palliative care: survey of specialists in the United Kingdom.

Authors:  H Pavis; A Wilcock
Journal:  BMJ       Date:  2001-09-01

Review 8.  Unlicensed and off-label drug use in children: implications for safety.

Authors:  Imti Choonara; Sharon Conroy
Journal:  Drug Saf       Date:  2002       Impact factor: 5.606

9.  Frequency of adverse drug reactions in children: a prospective study.

Authors:  Annie Pierre Jonville-Béra; Bruno Giraudeau; Pascal Blanc; Frèdèrique Beau-Salinas; Elisabeth Autret-Leca
Journal:  Br J Clin Pharmacol       Date:  2002-02       Impact factor: 4.335

10.  Research with children. Paediatric practice needs better evidence--gained in collaboration with parents and children.

Authors:  R L Smyth
Journal:  BMJ       Date:  2001-06-09
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