Centre for Paediatric Pharmacy Research, The School of Pharmacy, University of London and Institute of Child Health, University College London, London, United Kingdom.
Pharmacol Res. 2010 Sep;62(3):243-8. doi: 10.1016/j.phrs.2010.04.006. Epub 2010 May 6.
Non-steroidal anti-inflammatory drugs (NSAIDs) and opioids are commonly prescribed drugs which are frequently used for the treatment of various painful conditions. However, particularly for the paediatric population, there is a lack of information on effectiveness, safety and appropriate formulation resulting in off-label use and undertreatment. The aim of this study was to investigate the prescribing patterns of non-steroid anti-inflammatory drugs and opioids in children and adolescents in three European countries. A retrospective cohort study was conducted using the same protocol in three primary care databases: Pedianet (Italy), IPCI (Netherlands) and IMS Disease Analyzer (UK). User prevalence rates were calculated for opioids (N02A) and non-steroidal anti-inflammatory drugs (NSAIDs) (M01A) based on ATC therapeutic and chemical levels and stratified by country, age and gender. The prescribing prevalence for NSAIDs was lower in the Netherlands compared to Italy and the UK. Ibuprofen was the most frequently prescribed drug in this group in Italy (20.8 users/1000 PY) and the UK (30.6 users/1000 PY) whereas diclofenac was dominant in the Netherlands (1.7 users/1000 PY). Among opioids, codeine and codeine combinations were most commonly prescribed; only little use was seen for other drugs. There is a great variety of different NSAIDs and opioids prescribed to children in Europe in primary care. This is due to a varying availability of drugs in different countries but also because of differing prescribing attitudes, reimbursement scheme and a lack of data on the effectiveness of individual drugs. Further research into the rationale for prescribing these drugs to children is clearly needed.
非甾体抗炎药（NSAIDs）和阿片类药物是常用的处方药物，常用于治疗各种疼痛病症。然而，特别是对于儿科人群，关于其疗效、安全性和适当剂型的信息有限，导致了这些药物的标签外使用和治疗不足。本研究旨在调查三种欧洲国家儿童和青少年中 NSAIDs 和阿片类药物的处方模式。使用相同的方案，在三个初级保健数据库中进行了回顾性队列研究：Pedianet（意大利）、IPCI（荷兰）和 IMS Disease Analyzer（英国）。根据 ATC 治疗和化学分类，按国家、年龄和性别分层，计算了阿片类药物（N02A）和非甾体抗炎药（NSAIDs）（M01A）的用户流行率。与意大利和英国相比，荷兰的 NSAIDs 处方流行率较低。在意大利（20.8 名使用者/1000 PY）和英国（30.6 名使用者/1000 PY），布洛芬是该组中最常开的药物，而在荷兰，双氯芬酸则占主导地位（1.7 名使用者/1000 PY）。在阿片类药物中，最常开的是可待因和可待因组合；其他药物的使用量则较少。在欧洲初级保健中，儿童使用的 NSAIDs 和阿片类药物种类繁多。这是由于不同国家的药物供应情况不同，也由于不同的处方态度、报销计划以及缺乏关于个别药物疗效的数据所致。显然需要进一步研究为儿童开具这些药物的理由。
