Drug utilisation patterns in hospitalised children: An international perspective

Abstract

Aim/Objective: The majority of published drug utilisation studies in children come from primary care. Our aim was to investigate and compare patterns of drug therapy in hospitalised children in fi ve European and Non-European countries using a standardised protocol and terminologies. Methods: A prospective cohort study was conducted on paediatric medical wards in UK, Germany, Australia, Hong Kong (HK), and Malaysia. Drugs prescribed were classifi ed using WHO Anatomical Therapeutic Chemical (ATC) classifi cation. The frequency of prescriptions and exposure rates were calculated at ATC anatomic and therapeutic levels overall and stratifi ed by country. Results: 1278 patients were included (Australia 146, Germany 376, UK 313, HK 143, Malaysia 300). 1140 patients (89.2%) received 5367 prescriptions, median 3 per patient (IQR 2-5). The three most frequently prescribed therapeutic groups were; systemic antibacterials [1355 (25.3%), exposure (65.1%)], analgesics/ NSAIDs [1172 (21.8%), exposure (63.6%)], ‘drugs for obstructive airway diseases’ [472 (8.8%), exposure (23.6%)]. Number of patients exposed to these groups differed signifi cantly between countries p<0.05. Patients’ exposure to systemic antibacterials was highest in Malaysia (84.7%), lowest in HK (37.1%). Patients’ exposure to analgesics/NSAIDs varied signifi cantly between countries being highest in UK (84.2%,) and lowest in HK (35,3%), p<0.001. Paracetamol was the most frequent analgesic/NSAID in 4 countries. Metamizol was only prescribed in Germany whereas morphine was predominantly prescribed in the UK. Conclusion: This study shows that there are similarities but also signifi cant differences in drug utilisation patterns in hospitalised children across countries. Rational drug therapy has to be further investigated and promoted in paediatric medicine.