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Evaluation of Off-label Prescribing at a Children's Rehabilitation Center.

AbstractOBJECTIVE:
This study was developed to evaluate the incidence of off-label prescribing at a pediatric rehabilitation center. Secondary objectives were to describe the medications, patient age groups, and diagnoses most often associated with off-label prescribing.
METHODS:
This was a prospective observational study conducted at an academic, inpatient children's rehabilitation center from November 11, 2011, to April 1, 2012. Patients younger than 16 years of age who received at least 1 prescription medication were included. Data were collected from the patients' electronic medical records.
RESULTS:
A total of 240 medications orders were placed during the study, with 57% written off-label. Thirty-five patients (88%) received at least 1 off-label medication. Forty-nine percent of the orders were for patients younger than the approved range, with 48% written for an unapproved indication, 2% for an alternative route of administration, and 1% for an unapproved age and indication. Children 2 to 12 years of age received 40% of the off-label orders, followed by adolescents with 37%. The therapeutic classes most often prescribed off-label were central nervous system agents and anti-infectives.
CONCLUSION:
Off-label prescribing was found in the majority of children receiving rehabilitative services, a rate as high or higher than that reported in pediatric acute care or clinic settings. The medications prescribed off-label most often were central nervous system agents, reflecting the need to study medications in the chronic rehabilitation population to optimize function in children with brain or spinal cord injury.
AuthorsKyle E Luedtke, Marcia L Buck
JournalThe journal of pediatric pharmacology and therapeutics : JPPT : the official journal of PPAG (J Pediatr Pharmacol Ther) 2014 Oct-Dec Vol. 19 Issue 4 Pg. 296-301 ISSN: 1551-6776 [Print] United States
PMID25762875 (Publication Type: Journal Article)

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