Helms Peter J, Ekins Daukes Suzie, Taylor Michael W, Simpson Colin R, McLay James S
Department of Child Health, School of Medicine, University of Aberdeen, UK.
Br J Clin Pharmacol. 2005 Jun;59(6):684-90. doi: 10.1111/j.1365-2125.2005.02404.x.
The majority of medicines prescribed for children are prescribed in primary care for common acute and chronic conditions. This is in contrast to prescribing in secondary care where the population of children admitted is small but where a large number of different medicines are prescribed to treat more serious and less common conditions.
Data on prescribing was extracted from the General Practice Administration System for Scotland (GPASS) for the year November 1999 to October 2000 and prescribing patterns for children aged 0-16 years expressed as percentages. A comparison of age specific consultations for asthma, as an example of a common paediatric condition, was also made between two separate general practice data sets, the General Practice Research Database (GRPD) and the continuous morbidity recording (CMR) subset of GPASS.
Of 214 medicines investigated for unlicensed and off-label prescribing no unlicensed prescribing was identified. Off-label prescribing due to age was most common among younger and older children. The most common reasons for off-label prescriptions were, in order of frequency, lower than recommended dose, higher than recommended dose, below the recommended age, and unlicensed formulation. Age and gender specific consultations for asthma were similar in the two representative databases, GPRD and CMR, both showing disappearance of the male predominance in the teenage years.
Large primary care data sets available within a unified health care system such as the UK National Health Service (NHS) are likely to be broadly compatible and produce similar results. The prescribing of off-label medicines to children is common in primary care, most commonly due to prescribing out with the recommended dosage regimen.
为儿童开具的大多数药物是在初级保健中针对常见的急性和慢性疾病开具的。这与二级保健中的开药情况形成对比，在二级保健中，入院儿童数量较少，但会开出大量不同药物来治疗更严重和不太常见的疾病。
从苏格兰全科医疗管理系统（GPASS）中提取了1999年11月至2000年10月期间的开药数据，并以百分比形式呈现了0至16岁儿童的开药模式。作为常见儿科疾病的一个例子，还对两个独立的全科医疗数据集——全科医疗研究数据库（GRPD）和GPASS的连续发病率记录（CMR）子集——中的哮喘年龄特异性会诊情况进行了比较。
在对214种药物进行的未获许可和超说明书用药处方调查中，未发现未获许可的处方。因年龄导致的超说明书用药在幼儿和年长儿童中最为常见。超说明书处方最常见的原因按频率依次为低于推荐剂量、高于推荐剂量、低于推荐年龄和未获许可的剂型。在两个代表性数据库GRPD和CMR中，哮喘的年龄和性别特异性会诊情况相似，两者均显示青少年时期男性优势消失。
在英国国家医疗服务体系（NHS）这样统一的医疗保健系统中可用的大型初级保健数据集可能具有广泛的兼容性并产生相似的结果。在初级保健中，给儿童开具超说明书药物的情况很常见，最常见的原因是开出的剂量超出了推荐的用药方案。
