Off-label prescribing to children: attitudes and experience of general practitioners.
OBJECTIVE
To identify experience with and attitudes towards paediatric off-label prescribing in primary care.


METHODS
A prospective questionnaire survey was sent to a sample of Scottish primary care practices (346 doctors in 80 general practices located throughout Scotland).


RESULTS
Two hundred and two (58%) completed questionnaires were returned. Over 70% of GPs admitted to being familiar with the concept, and 40% to knowingly prescribing off-label. The most important sources of paediatric prescribing information were the British National Formulary (81%), personal experience (71%) and previous prescription notes (45%). The most common reason given by GPs for off-label prescribing was prescribing for a younger age than recommended, although prescribing data confirm that age is the least important and dose the most important reason for such prescribing. When asked to comment upon different causes for off-label prescribing, 80% of respondents expressed appropriate awareness of and concern for the described scenarios. Over 97% of GPs ranked development of paediatric formulations and clearer dosage information more highly than clinical trials as a means to reducing off-label prescribing.


CONCLUSIONS
Despite high levels of off-label prescribing in primary care in the UK, the majority of GPs claimed to be familiar with the concept, although less than half were aware of this common practice. A clear disparity between perceived and actual reasons for off-label prescribing was noted, possibly due to a reliance on personal experience, colleague experience or previous patient prescription notes as a guide to prescribing.
Ekins-Daukes
Suzie
S
Department of Medicine and Therapeutics, The University of Aberdeen, UK.
Helms
Peter J
PJ
Taylor
Michael W
MW
McLay
James S
JS
D000420:Albuterol / Q000008:administration & dosage; D018926:Anti-Allergic Agents / Q000008:administration & dosage; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D001993:Bronchodilator Agents / Q000008:administration & dosage; D017332:Cetirizine / Q000008:administration & dosage; D002648:Child; D002675:Child, Preschool; D004334:Drug Administration Schedule; D004346:Drug Information Services; D004348:Drug Labeling; D011307:Drug Prescriptions; D004917:Erythromycin / Q000008:administration & dosage; D005194:Family Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D017336:Loratadine / Q000008:administration & dosage; D010404:Penicillin V / Q000008:administration & dosage; D011446:Prospective Studies; D012606:Scotland
D018926:Anti-Allergic Agents; D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents; D004917:Erythromycin; D017336:Loratadine; D000420:Albuterol; D017332:Cetirizine; D010404:Penicillin V