Quality of prescribing for children in general practice

In a feasibility study of how often doctors prescribe drugs inappropriately for children 6331 FP10 forms issued to children in September 1978 by a random sample of 72 general practitioners in Wessex were examined. Prescriptions for drugs long known to be contraindicated in children--for instance, chloramphenicol, barbiturates, tetracyclines, and those with effects on appetite--were not encountered. Most scripts were for one drug only. Only about 1% (80/6331) of prescriptions could legitimately be called into question on the basis of current modern specialist teaching, although 42% of the doctors used drugs that have recently been considered to be hazardous or undesirable. These were predominantly drugs to control the symptoms of diarrhoea, vomiting, and enuresis. It is concluded that aspects of prescribing for children are responsible in the main but that there is a lag in the availability or use of important information relevant to general practice. The approach used in this study is applicable to many other areas of clinical practice and does not threaten individual doctors. It may prove to be a convenient way of assessing the general quality of medical care for children.