Impact of safety alerts upon prescribing of cisapride to children in New Zealand.
OBJECTIVE
To assess the volume of cisapride prescribed in New Zealand to children age 0-17 years and establish whether safety announcements on cisapride had an effect on prescription volumes.


METHODS
The Pharm warehouse database, which includes prescribing data from the New Zealand Health Information Service, was searched for all prescriptions for cisapride, ranitidine and omeprazole to children age 0-5 and 6-17 years inclusive, from January 1993 to October 2001. The amount of cisapride prescribed, and subsequently dispensed, was tabulated by month, using ranitidine and omeprazole as comparison groups. The time-course of prescribing patterns were compared with the timing of Medsafe alerts regarding cisapride.


RESULTS
There were a total of 27169 prescriptions for cisapride over the time-period studied. For both age groups cisapride prescription numbers increased through the mid 1990 s to reach a peak prior to 1998. The prescription volumes declined following the Medsafe alerts, with the peak in prescribing by paediatricians occurring twelve months prior to that for general practitioners. Ranitidine and omeprazole prescriptions continued to rise in the younger age group throughout the study.


CONCLUSIONS
The volume of cisapride prescribed in children has decreased dramatically since 1998 following the Medsafe alerts but the trends indicated delay in the response to safety announcements.
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020117:Cisapride / Q000009:adverse effects*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D009520:New Zealand; D009853:Omeprazole / Q000627:therapeutic use; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011899:Ranitidine / Q000627:therapeutic use; D017751:Safety Management / Q000706:statistics & numerical data*
D011899:Ranitidine; D009853:Omeprazole; D020117:Cisapride