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Drug utilization in pediatric neurology outpatient department: A prospective study at a tertiary care teaching
Krutika M Bhatt1, Supriya D Malhotra1, Kamlesh P Patel1
1Department of Pharmacology, Smt. NHL Municipal Medical College, Ahmedabad, Gujarat, India.
Insights
Pediatric neurology patients commonly have epilepsy, with sodium valproate as the most prescribed drug. Some prescriptions involved off-label or unlicensed medications, and many showed potential drug interactions.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacy
- Pharmacovigilance
Background:
- Neurological disorders significantly impact pediatric patients' quality of life in India.
- Late presentation is common, with many pediatric patients receiving off-label or unlicensed medications.
Purpose of the Study:
- To analyze drug utilization patterns in pediatric neurology outpatients.
- To identify off-label/unlicensed drug use and potential drug-drug interactions.
Main Methods:
- Prospective collection and analysis of 140 prescriptions over 8 weeks.
- Evaluation of prescribing patterns, WHO core indicators, and drug interactions.
Main Results:
- Epilepsy was the most frequent diagnosis (73.57%).
- Sodium valproate was the most prescribed drug (25.11%).
- Off-label/unlicensed drug use occurred in 8.57% of cases, with 26% showing potential drug interactions.
Conclusions:
- Epilepsy is the predominant neurological condition in pediatric patients.
- Sodium valproate is the leading prescribed medication.
- A notable percentage of prescriptions involved off-label/unlicensed drugs and potential interactions.
Background:
Neurological disorders are a significant cause of morbidity, mortality and adversely affect quality of life among pediatric patients. In India, more than 30% population is under 20 years of age, many of whom present late during the course of illness. Several drugs prescribed to pediatric population suffering from neurological disorders may be off label or unlicensed.
Aims And Objectives:
To study drug use pattern, identify off-label/unlicensed drug use and to check potential for drug-drug interactions in patients attending outpatient department of pediatric neurology at a tertiary care teaching hospital.
Methodology:
Prescriptions of patients attending pediatric neurology outpatient department were collected prospectively for 8 weeks. They were analyzed for prescribing pattern, WHO core prescribing indicators, off-label/unlicensed drug use and potential for drug-drug interactions.
Result:
A total of 140 prescriptions were collected, male female ratio being 2:1. Epilepsy was the most common diagnosis (73.57%) followed by breath holding spells, migraine and developmental disorders. Partial seizure was the most common type of epilepsy (52.42%). Average number of drugs prescribed per patient was 1.56. Most commonly prescribed drug was sodium valproate (25.11%) followed by phenytoin (11.41%). About 16% of the prescriptions contained newer antiepileptic drugs. More than 60% of the drugs were prescribed from WHO essential drug list. In 8.57% of cases drugs were prescribed in off-label/unlicensed manner. Twenty-six percent prescriptions showed potential for drug interactions.
Conclusion:
Epilepsy is the most common neurological disease among children and adolescents. Sodium valproate is the most commonly prescribed drug. A few prescriptions contained off-label/unlicensed drugs.
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