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埃塞俄比亚西北部贡德尔大学转诊医院住院儿童的非适应证用药:一项前瞻性观察性研究

Off-label drug use in hospitalized children: a prospective observational study at Gondar University Referral Hospital, Northwestern Ethiopia.

作者信息

Tefera Yonas G, Gebresillassie Begashaw M, Mekuria Abebe B, Abebe Tamrat B, Erku Daniel A, Seid Nurahmed, Beshir Habiba B

机构信息

Department of Clinical Pharmacy School of Pharmacy University of Gondar Gondar Amhara Ethiopia.

Department of Pharmacology School of Pharmacy University of Gondar Gondar Amhara Ethiopia.

出版信息

Pharmacol Res Perspect. 2017 Mar 17;5(2):e00304. doi: 10.1002/prp2.304. eCollection 2017 Apr.

Abstract

Most of the medications which are currently used for the treatment of childhood diseases are either not licensed or being prescribed outside the terms of the product license (off-label prescribing). This study aimed at determining the extent of unlicensed and off-label drug uses and associated factors in children hospitalized in Gondar University Referral Hospital, Northwest Ethiopia An institution-based prospective cross-sectional study was employed from April 15 to July 15, 2016. A total of 243 pediatric patients admitted to Gondar university referral hospital were included in the study using simple random sampling method. Data were collected using structured questionnaire, and the data collected were entered and analyzed using Statistical Packages for Social Sciences (SPSS) version 20. From the total of 800 drugs prescribed, 607 (75.8%) were off-label. Off-label medicine use was frequently observed in antimicrobials (60.6%) followed by central nervous system drugs (14.3%). The extent off-label prescribing was highest in age group of 6-13 years (30%). Inappropriate dosing and frequency (42.3%) were the most common reason for off-label medicine use. Having other variables controlled, age group and undergoing surgical procedure remained to be significant predictors of off-label prescribing in the multivariate regression analysis. Implementing evidence-based approach in prescribing by generating more quality literatures on the safety profile and effectiveness of off-label would improve the injudicious use of drugs in pediatric population.

摘要

目前用于治疗儿童疾病的大多数药物要么未获许可,要么是在产品许可范围之外开具处方(即超说明书用药)。本研究旨在确定埃塞俄比亚西北部贡德尔大学转诊医院住院儿童中未获许可和超说明书用药的程度及其相关因素。采用基于机构的前瞻性横断面研究,时间为2016年4月15日至7月15日。使用简单随机抽样方法,共纳入243名入住贡德尔大学转诊医院的儿科患者。通过结构化问卷收集数据,并使用社会科学统计软件包(SPSS)20版对收集的数据进行录入和分析。在总共开具的800种药物中,有607种(75.8%)为超说明书用药。超说明书用药在抗菌药物中最为常见(60.6%),其次是中枢神经系统药物(14.3%)。超说明书用药比例在6至13岁年龄组中最高(30%)。用药剂量和频率不当(42.3%)是超说明书用药最常见的原因。在多变量回归分析中,在控制其他变量的情况下,年龄组和接受外科手术仍然是超说明书用药的显著预测因素。通过生成更多关于超说明书用药安全性和有效性的高质量文献,在处方中实施循证方法将改善儿科人群中药物的不合理使用情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7cb0/5368968/e3ba336fb173/PRP2-5-e00304-g001.jpg

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