Prescription medicine use by one million Canadian children

Abstract

Drugs are an increasing and integral part of the treatment of childhood conditions. There is widespread concern regarding the inadequacy of paediatric data from clinical trials, which results in limited prescribing information available to support optimal pharmacotherapy for children. One explanation for the limited prescribing information in paediatrics is the perception of relatively infrequent use of drugs in the treatment of childhood conditions. To date there have been few population studies quantifying the extent of prescription drug use among Canadian children. Prescription information from administrative databases were available for over one million paediatric claimants likely representing approximately two million eligible children. Nearly 15% of Canadian children actually had a claim for a prescription drug recorded in this database. Descriptive statistics were employed to describe drug utilization for those who had a drug claim. The two largest therapeutic areas were antibiotics (76% of claimants) and respiratory drugs (18% of claimants). Among the top 20 drugs dispensed to paediatric claimants, 14 were antibiotics and the top drug overall was amoxicillin. Psychotropic drugs defined as stimulants, antidepressants, antipsychotics and anticonvulsants were dispensed to 6% of all paediatric claimants. In virtually every therapeutic area, the usage of drugs differed markedly across age groups. A wide range of drugs are prescribed to children, many of which are being used outside of the age ranges approved by Health Canada. However, most new drugs are used relatively infrequently in children. The large numbers of Canadian children documented in this study using prescription medicines reinforces the value of vigilance in ensuring that physicians are equipped with adequate information to ensure safe and effective prescribing. The use of therapeutic drugs is widespread, and for a large number of these drugs, safety and efficacy among children has not been established, although no conclusions can be drawn from this study about appropriateness of drug therapy in children. Consequently, ongoing vigilance in accurate paediatric labelling as well as future pharmacoepidemiologic studies addressing safety and efficacy are required. Efforts must be concentrated on those specific age ranges in which products or drug classes are used, evidence of which can be determined from actual utilization.