Service de pharmacologie médicale, CHU Bordeaux, Bordeaux, France.
CIC Bordeaux CIC1401, Bordeaux, France ADERA, Pessac, France.
Arch Dis Child. 2015 Oct;100(10):960-5. doi: 10.1136/archdischild-2014-307224. Epub 2015 May 14.
To provide an overview of drug use in outpatient children in France, a population-based study using a national reimbursement claims database representative of 90% of the French population was conducted.
Cross-sectional study performed between January and December 2011 using the EGB database (Echantillon Généraliste de Bénéficiaires), a 1/97th sample of the national healthcare insurance system beneficiaries. Drug use in children <18 years old was estimated through reimbursements for prescribed drugs excluding vaccines. Prevalences of use were calculated for different levels of the Anatomical Therapeutic Chemical classification by considering as users children who had at least one reimbursement during the study period.
In 2011, 133,800 children were included in the study. The overall prevalence of drug use was 84% and the median number of different drugs per child was 5. Drug use was greatest in children aged <2 years. The most widely used drugs were paracetamol, systemic anti-infectives, nasal corticosteroids and decongestants, and anti-histamines. 21% children <2 years received domperidone.
There is widespread use of medicines that are unlikely to be effective and may have significant toxicity in French children. Irrational use of medicines appears to be greatest in children aged 5 years and under.
本研究旨在提供法国门诊儿童用药情况概述,采用覆盖 90%法国人口的全国报销索赔数据库,进行基于人群的研究。
2011 年 1 月至 12 月期间,采用 EGB 数据库(Echantillon Généraliste de Bénéficiaires)进行横断面研究,该数据库是国家医疗保险系统受益人的 1/97 抽样。通过报销处方药(不包括疫苗)来估算<18 岁儿童的用药情况。考虑到在研究期间至少有一次报销的儿童为用药者,按解剖治疗化学分类的不同级别计算用药的流行率。
2011 年,纳入研究的儿童共 133800 名。总体用药流行率为 84%,中位数每名儿童使用的不同药物种类为 5 种。<2 岁儿童用药最广泛。最常用的药物是对乙酰氨基酚、全身抗感染药、鼻用皮质类固醇和减充血剂以及抗组胺药。<2 岁的儿童中有 21%使用了多潘立酮。
法国儿童广泛使用可能无效且可能具有显著毒性的药物。药物不合理使用在 5 岁及以下儿童中似乎最为严重。