Unlicensed and off-label medicines prescribed to children in primary care

The prescribing of unlicensed and off label medicines to children has become an area of concern due to risks of toxicity and side effects or suboptimal therapy. Current efforts to reduce this practice have so far concentrated on encouraging the pharmaceutical industry to conduct paediatric clinical trails where appropriate to increase the number of medicines licensed for paediatric use in the future. This work investigated off label prescribing, homeopathic prescribing and the co-prescribing of corticosteroid preparations in primary care in order to highlight other target areas for improving paediatric prescribing. Results: At least 1 off label prescription was issued to 17715 (26.1%) children. Prescribing outside the recommended dose was the most common from of off label prescribing with prescribing trends and GP responses to the questionnaire indicating that this may be inadvertent due to the wide variation in dose related age bandings for paediatric medicines. Homeopathic medicines were most commonly prescribed to infants (1.1%) with self-limiting conditions. GPs with a favourable opinion were found to influence the opinions of their partners. The co-prescribing of inhaled and nasal corticosteroids was common particularly in adolescents with the majority receiving a high total steroid burden. Conclusions: Off label prescribing in primary care could be reduced by standardising dose related age bandings for medicines based on major childhood physiological and developmental stages. Increased training in homeopathy and the presence of an interested partner may facilitate communication and ensure children receive optimal therapy. For children chronically prescribed more than one corticosteroid preparation consideration should be given to the total daily steroid burden to minimise potential adverse effects on growth and development.EThOS - Electronic Theses Online ServiceGBUnited Kingdo