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Healthcare professional experiences and attitudes on unlicensed/off-label paediatric prescribing and paediatric clinical trials

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Abstract

Objectives

To investigate the knowledge and views of a range of healthcare professionals (consultant paediatricians, general practitioners (GPs), community pharmacists and paediatric nurses) regarding the use of unlicensed/off-label medicines in children and the participation of children in clinical trials.

Methods

A regional study in which a survey instrument with 39 items was issued to 500 randomly selected GPs, all community pharmacists (n = 512), 50 hospital consultants and 150 paediatric nurses in Northern Ireland.

Results

Approximately half (46.5%) of the 1,212 healthcare professionals approached responded to the questionnaire. The majority of respondents indicated their familiarity with the term unlicensed (82.9%) or off-label (58.6%) prescribing with the most frequently quoted reason for such prescribing being younger age (33.6%). Apart from community pharmacists, most respondents reported having gained their knowledge through personal experience. Even though a large percentage of respondents expressed concerns about the safety (77.8%) or efficacy (87.9%) of unlicensed/off-label prescribing in children, only 30.7% reported informing parents/guardians of these concerns on the use of such medicines in children. In addition, only 56% of respondents believed that unlicensed/off-label medicines should undergo clinical trials in children. Overall, 28.4% of respondents (20.1% of GPs, 41.4% of community pharmacists, 27.7% of paediatric nurses and 94% of consultant paediatricians) indicated their willingness to be actively involved in, and recruit their patients for paediatric clinical research.

Conclusion

The use of unlicensed and off-label medicines remains a major issue in paediatric medicine. Until such times as more licensed medicines are available for children, clear guidance should be developed to allow consistency in practice across the spectrum of healthcare professionals who are involved with such medicines in their routine practice.

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Conflict of interests

The authors declare that they have no conflict of interest.

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Author notes

  1. Tareq Mukattash

    Present address: Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, 22110, Jordan

Authors and Affiliations

  1. Clinical and Practice Research Group, School of Pharmacy, Medical Biology Centre, Queen’s University Belfast, 97 Lisburn Road, BT9 7BL, Belfast, UK

    Tareq Mukattash, Ahmed F. Hawwa & James C. McElnay

  2. School of Psychology, Queen’s University, BT7 1NN, Belfast, UK

    Karen Trew

Authors
  1. Tareq Mukattash
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  2. Ahmed F. Hawwa
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  3. Karen Trew
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  4. James C. McElnay
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Corresponding author

Correspondence to James C. McElnay.

Appendix 1: The use of unlicensed and off-label medicines in children

Appendix 1: The use of unlicensed and off-label medicines in children

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Mukattash, T., Hawwa, A.F., Trew, K. et al. Healthcare professional experiences and attitudes on unlicensed/off-label paediatric prescribing and paediatric clinical trials. Eur J Clin Pharmacol 67, 449–461 (2011). https://doi.org/10.1007/s00228-010-0978-z

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  • DOI: https://doi.org/10.1007/s00228-010-0978-z

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