Drug use in children: cohort study in three European countries
Identifieur interne : 000005 ( Istex/Corpus ); précédent : 000004; suivant : 000006Drug use in children: cohort study in three European countries
Auteurs : Miriam C J M. Sturkenboom ; Katia M C. Verhamme ; Alfredo Nicolosi ; Macey L. Murray ; Antje Neubert ; Daan Caudri ; Gino Picelli ; Elif Fatma Sen ; Carlo Giaquinto ; Luigi Cantarutti ; Paola Baiardi ; Maria-Grazia Felisi ; Adriana Ceci ; Ian C K. WongSource :
- BMJ [ 0959-8138 ] ; 2008.
Abstract
Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.
Url:
DOI: 10.1136/bmj.a2245
Links to Exploration step
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<front><div type="abstract">Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.</div>
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<abstract>Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (>1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.</abstract>
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<note type="biography">director</note>
<affiliation>director</affiliation>
<affiliation>Department of Epidemiology and Medical Informatics, Institute of Biomedical Technologies, National Research Council, 20090 Segrate, Milan, Italy</affiliation>
<affiliation>GH Sergievsky Center, School of Public Health, Columbia University, New York, NY 10032, US</affiliation>
</author>
<author><persName><forename type="first">Macey L</forename>
<surname>Murray</surname>
</persName>
<note type="biography">teaching and research fellow</note>
<affiliation>teaching and research fellow</affiliation>
<affiliation>Centre for Paediatric Pharmacy Research, School of Pharmacy and Institute of Child Health, University of London, London WC1N 1AX</affiliation>
</author>
<author><persName><forename type="first">Antje</forename>
<surname>Neubert</surname>
</persName>
<note type="biography">postdoctoral research fellow</note>
<affiliation>postdoctoral research fellow</affiliation>
<affiliation>Centre for Paediatric Pharmacy Research, School of Pharmacy and Institute of Child Health, University of London, London WC1N 1AX</affiliation>
</author>
<author><persName><forename type="first">Daan</forename>
<surname>Caudri</surname>
</persName>
<note type="biography">researcher</note>
<affiliation>researcher</affiliation>
<affiliation>Department of Medical Informatics, Erasmus University Medical Centre, 3000CA Rotterdam, Netherlands</affiliation>
</author>
<author><persName><forename type="first">Gino</forename>
<surname>Picelli</surname>
</persName>
<note type="biography">analyst</note>
<affiliation>analyst</affiliation>
<affiliation>International Pharmacoepidemiology and Pharmacoeconomics Research Centre, 20033 Desio, Italy</affiliation>
</author>
<author><persName><forename type="first">Elif Fatma</forename>
<surname>Sen</surname>
</persName>
<note type="biography">PhD student</note>
<affiliation>PhD student</affiliation>
<affiliation>Department of Medical Informatics, Erasmus University Medical Centre, 3000CA Rotterdam, Netherlands</affiliation>
</author>
<author><persName><forename type="first">Carlo</forename>
<surname>Giaquinto</surname>
</persName>
<note type="biography">head of clinical research unit</note>
<affiliation>head of clinical research unit</affiliation>
<affiliation>Department of Paediatrics, University Hospital, Padua, Italy</affiliation>
</author>
<author><persName><forename type="first">Luigi</forename>
<surname>Cantarutti</surname>
</persName>
<note type="biography">director</note>
<affiliation>director</affiliation>
<affiliation>Società Servizi Telematici 35138 Padua, Italy</affiliation>
</author>
<author><persName><forename type="first">Paola</forename>
<surname>Baiardi</surname>
</persName>
<note type="biography">director</note>
<affiliation>director</affiliation>
<affiliation>Consorzio per Valutazioni Biologiche e Farmacologiche, 27100 Pavia, Italy</affiliation>
</author>
<author><persName><forename type="first">Maria-Grazia</forename>
<surname>Felisi</surname>
</persName>
<note type="biography">researcher</note>
<affiliation>researcher</affiliation>
<affiliation>Consorzio per Valutazioni Biologiche e Farmacologiche, 27100 Pavia, Italy</affiliation>
</author>
<author><persName><forename type="first">Adriana</forename>
<surname>Ceci</surname>
</persName>
<note type="biography">scientific coordinator</note>
<affiliation>scientific coordinator</affiliation>
<affiliation>Consorzio per Valutazioni Biologiche e Farmacologiche, 27100 Pavia, Italy</affiliation>
</author>
<author><persName><forename type="first">Ian C K</forename>
<surname>Wong</surname>
</persName>
<note type="biography">professor of paediatric medicines research</note>
<affiliation>professor of paediatric medicines research</affiliation>
<affiliation>Centre for Paediatric Pharmacy Research, School of Pharmacy and Institute of Child Health, University of London, London WC1N 1AX</affiliation>
</author>
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<abstract><p>Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.</p>
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<article-categories><subj-group subj-group-type="heading"><subject>Research</subject>
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<subj-group subj-group-type="hwp-journal-coll"><subject>Epidemiologic studies</subject>
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<subj-group subj-group-type="hwp-journal-coll"><subject>General practice / family medicine</subject>
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<title-group><article-title>Drug use in children: cohort study in three European countries</article-title>
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<contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Sturkenboom</surname>
<given-names>Miriam C J M</given-names>
</name>
<role>professor in analysis of observational data</role>
<xref ref-type="aff" rid="aff1">1</xref>
<xref ref-type="aff" rid="aff2">2</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Verhamme</surname>
<given-names>Katia M C</given-names>
</name>
<role>assistant professor in pharmacoepidemiology</role>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Nicolosi</surname>
<given-names>Alfredo</given-names>
</name>
<role>director</role>
<xref ref-type="aff" rid="aff3">3</xref>
<role>senior associate research scientist</role>
<xref ref-type="aff" rid="aff4">4</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Murray</surname>
<given-names>Macey L</given-names>
</name>
<role>teaching and research fellow</role>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Neubert</surname>
<given-names>Antje</given-names>
</name>
<role>postdoctoral research fellow</role>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Caudri</surname>
<given-names>Daan</given-names>
</name>
<role>researcher</role>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Picelli</surname>
<given-names>Gino</given-names>
</name>
<role>analyst</role>
<xref ref-type="aff" rid="aff6">6</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Sen</surname>
<given-names>Elif Fatma</given-names>
</name>
<role>PhD student</role>
<xref ref-type="aff" rid="aff1">1</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Giaquinto</surname>
<given-names>Carlo</given-names>
</name>
<role>head of clinical research unit</role>
<xref ref-type="aff" rid="aff7">7</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Cantarutti</surname>
<given-names>Luigi</given-names>
</name>
<role>director</role>
<xref ref-type="aff" rid="aff8">8</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Baiardi</surname>
<given-names>Paola</given-names>
</name>
<role>director</role>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Felisi</surname>
<given-names>Maria-Grazia</given-names>
</name>
<role>researcher</role>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Ceci</surname>
<given-names>Adriana</given-names>
</name>
<role>scientific coordinator</role>
<xref ref-type="aff" rid="aff9">9</xref>
</contrib>
<contrib contrib-type="author" corresp="no"><name><surname>Wong</surname>
<given-names>Ian C K</given-names>
</name>
<role>professor of paediatric medicines research</role>
<xref ref-type="aff" rid="aff5">5</xref>
</contrib>
<on-behalf-of>on behalf of the TEDDY European Network of Excellence</on-behalf-of>
<aff id="aff1"><label>1</label>
Department of Medical Informatics, Erasmus University Medical Centre, 3000CA Rotterdam, Netherlands</aff>
<aff id="aff2"><label>2</label>
Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, Netherlands</aff>
<aff id="aff3"><label>3</label>
Department of Epidemiology and Medical Informatics, Institute of Biomedical Technologies, National Research Council, 20090 Segrate, Milan, Italy</aff>
<aff id="aff4"><label>4</label>
GH Sergievsky Center, School of Public Health, Columbia University, New York, NY 10032, US</aff>
<aff id="aff5"><label>5</label>
Centre for Paediatric Pharmacy Research, School of Pharmacy and Institute of Child Health, University of London, London WC1N 1AX</aff>
<aff id="aff6"><label>6</label>
International Pharmacoepidemiology and Pharmacoeconomics Research Centre, 20033 Desio, Italy</aff>
<aff id="aff7"><label>7</label>
Department of Paediatrics, University Hospital, Padua, Italy</aff>
<aff id="aff8"><label>8</label>
Società Servizi Telematici 35138 Padua, Italy</aff>
<aff id="aff9"><label>9</label>
Consorzio per Valutazioni Biologiche e Farmacologiche, 27100 Pavia, Italy</aff>
</contrib-group>
<author-notes><corresp>Correspondence to: M C J M Sturkenboom <email>m.sturkenboom@erasmusmc.nl</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><year>2008</year>
</pub-date>
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<month>11</month>
<year>2008</year>
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<elocation-id>a2245</elocation-id>
<history><date date-type="accepted"><day>1</day>
<month>September</month>
<year>2008</year>
</date>
</history>
<permissions><copyright-statement>© Sturkenboom et al 2008</copyright-statement>
<copyright-year>2008</copyright-year>
<copyright-holder>Sturkenboom et al</copyright-holder>
<license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/2.0/"><p>This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
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<abstract><p><bold>Objective</bold>
To provide an overview of drug use in children in three European countries.</p>
<p><bold>Design</bold>
Retrospective cohort study, 2000-5.</p>
<p><bold>Setting</bold>
Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet).</p>
<p><bold>Participants</bold>
675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands).</p>
<p><bold>Main outcome measure</bold>
Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class.</p>
<p><bold>Results</bold>
Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label.</p>
<p><bold>Conclusion</bold>
This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.</p>
</abstract>
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<topic>Contraception</topic>
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<subject><genre>hwp-journal-coll</genre>
<topic>Drugs: obstetrics and gynaecology</topic>
</subject>
<subject><genre>hwp-journal-coll</genre>
<topic>Reproductive medicine</topic>
</subject>
<subject><genre>hwp-journal-coll</genre>
<topic>Chemotherapy</topic>
</subject>
<subject><genre>hwp-journal-coll</genre>
<topic>Child health</topic>
</subject>
<subject><genre>hwp-journal-coll</genre>
<topic>Asthma</topic>
</subject>
<subject><genre>hwp-journal-coll</genre>
<topic>Drugs: respiratory system</topic>
</subject>
<originInfo><publisher>British Medical Journal Publishing Group</publisher>
<dateIssued encoding="w3cdtf">2008</dateIssued>
<dateCreated encoding="w3cdtf">2008-11-24</dateCreated>
<copyrightDate encoding="w3cdtf">2008</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="iso639-2b">eng</languageTerm>
<languageTerm type="code" authority="rfc3066">en</languageTerm>
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<abstract>Objective To provide an overview of drug use in children in three European countries. Design Retrospective cohort study, 2000-5. Setting Primary care research databases in the Netherlands (IPCI), United Kingdom (IMS-DA), and Italy (Pedianet). Participants 675 868 children aged up to 14 (Italy) or 18 (UK and Netherlands). Main outcome measure Prevalence of use per year calculated by drug class (anatomical and therapeutic). Prevalence of “recurrent/chronic” use (three or more prescriptions a year) and “non-recurrent” or “acute” use (less than three prescriptions a year) within each therapeutic class. Descriptions of the top five most commonly used drugs evaluated for off label status within each anatomical class. Results Three levels of drug use could be distinguished in the study population: high (>10/100 children per year), moderate (1-10/100 children per year), and low (<1/100 children per year). For all age categories, anti-infective, dermatological, and respiratory drugs were in the high use group, whereas cardiovascular and antineoplastic drugs were always in the low use group. Emollients, topical steroids, and asthma drugs had the highest prevalence of recurrent use, but relative use of low prevalence drugs was more often recurrent than acute. In the top five highest prevalence drugs topical inhaled and systemic steroids, oral contraceptives, and topical or systemic antifungal drugs were most commonly used off label. Conclusion This overview of outpatient paediatric prescription patterns in a large European population could provide information to prioritise paediatric therapeutic research needs.</abstract>
<relatedItem type="host"><titleInfo><title>BMJ</title>
</titleInfo>
<titleInfo type="abbreviated"><title>BMJ</title>
</titleInfo>
<genre type="Journal">journal</genre>
<identifier type="ISSN">0959-8138</identifier>
<identifier type="eISSN">1468-5833</identifier>
<identifier type="PublisherID">bmj</identifier>
<identifier type="PublisherID-hwp">bmj</identifier>
<identifier type="PublisherID-nlm-ta">BMJ</identifier>
<part><date>2008</date>
<detail type="volume"><caption>vol.</caption>
<number>337</number>
</detail>
</part>
</relatedItem>
<identifier type="istex">1875612FEB7E6F371BD0A200D80D6C7A3CAA3B59</identifier>
<identifier type="DOI">10.1136/bmj.a2245</identifier>
<identifier type="href">bmj-337-bmj-a2245.pdf</identifier>
<identifier type="ArticleID">stum531863</identifier>
<identifier type="PMID">19029175</identifier>
<identifier type="local">bmj;337/nov24_2/a2245</identifier>
<accessCondition type="use and reproduction" contentType="open-access">This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</accessCondition>
<recordInfo><recordContentSource>BMJ</recordContentSource>
<recordOrigin>Sturkenboom et al</recordOrigin>
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