Attitudes and experiences of community pharmacists towards paediatric off-label prescribing: a prospective survey.
OBJECTIVE
To identify community pharmacist experiences of, and attitudes towards paediatric off-label prescribing.


METHODS
A prospective questionnaire-based study, with a 21-item questionnaire issued to 1500 randomly selected community pharmacies throughout the UK during 2005 on three separate occasions.


RESULTS
Four hundred and eighty-two (32.1%) completed questionnaires were returned. Over 70% of respondents were familiar with the concept of off-label prescribing, primarily through dispensing experience rather than education, although only 40% were aware of having dispensed a paediatric off-label prescription within the previous month. The reasons given for a prescription being off label were younger age than recommended (84.6%, 297/351), primarily for antihistamines, analgesics and beta(2)-agonists, and higher (73.9%, 229/310) or lower than (41%, 103/258) recommended dose, primarily antibiotics and analgesics. Over 60% of respondents had been asked by the public to sell paediatric over-the-counter medicines, such as antihistamines, analgesics and steroid preparations for off-label use. The majority of respondents used the British National Formulary or the Pack Insert rather than specialist formularies or guidelines as a source of specialist paediatric information. Although 78% of respondents believed they had a responsibility to inform the prescriber that a medicine was off label, only 66% believed that they had a similar responsibility to inform parents.


CONCLUSIONS
The community pharmacists who responded to this questionnaire appear to be aware of and concerned by the issues which surround paediatric off-label prescribing. Despite this, most gained relevant knowledge through work experience rather than undergraduate or postgraduate training or professional development.
Stewart
Derek
D
Department of Medicine and Therapeutics, University of Aberdeen, Aberdeen, UK.
Rouf
Abdul
A
Snaith
Ailsa
A
Elliott
Kathleen
K
Helms
Peter J
PJ
McLay
James S
JS
D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D002648:Child; D002675:Child, Preschool; D017277:Drug Approval / Q000331:legislation & jurisprudence*; D004348:Drug Labeling / Q000331:legislation & jurisprudence*; D011307:Drug Prescriptions; D004363:Drug Utilization; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D010595:Pharmacists / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011247:Pregnancy; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D006113:United Kingdom