title: Audit of domperidone use as a galactogogue at an Australian tertiary teaching hospital.
abstract: BACKGROUND
  Domperidone is often used to promote lactation among women who have difficulty breastfeeding.
  
  
  OBJECTIVE
  To examine prescribing and dispensing practices of domperidone at the Women's and Children's Hospital (WCH), Adelaide.
  
  
  METHODS
  A retrospective audit of domperidone dispensing among women with singleton pregnancies who delivered at the WCH between January 2000 and July 2010 was undertaken. Women dispensed domperidone were identified using WCH pharmacy dispensing records. Maternal and infant clinical data were obtained from the WCH Perinatal Statistics Collection. An audit of paper-based medical records was undertaken for a random sample of 261 mother-child pairs to collect prescribing and additional clinical data.
  
  
  RESULTS
  From 2000 to 2010, 1605 women were dispensed domperidone. There was a steady increase in the percentage of women dispensed domperidone, from < 0.5% in 2000 to > 5% of total WCH pregnancies in 2010. Among women dispensed domperidone, the percentage of women who received > 1 dispensing remained consistent (20%) over time, as did the median number of days (12) from delivery to first dispensing. Multiparous women were more likely to receive domperidone within 3 days following delivery compared to primiparous women (8% vs 4%; P < .01). Most women (80%) received directions to take domperidone according to a standard tapering dosing regimen over 12 days. Notably, 60% of women had no documentation of being assessed by a lactation consultant.
  
  
  CONCLUSIONS
  From 2000 to 2010, there was a considerable increase in domperidone dispensing. With a lack of clinical evidence to guide use, current practice appears to be based on anecdotal evidence.
authors.affiliation: Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Sciences, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia. grzly001@mymail.unisa.edu.au
authors.forename: Luke E
authors.initials: LE
authors.lastname: Grzeskowiak
authors.forename: Sze Wen
authors.initials: SW
authors.lastname: Lim
authors.forename: Alicia E
authors.initials: AE
authors.lastname: Thomas
authors.forename: Usha
authors.initials: U
authors.lastname: Ritchie
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Gordon
mesh_terms: D000328:Adult; D001315:Australia; D001724:Birth Weight; D004294:Domperidone / Q000008:administration & dosage* / Q000627:therapeutic use; D018492:Dopamine Antagonists / Q000008:administration & dosage* / Q000627:therapeutic use; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D056669:Galactogogues / Q000008:administration & dosage* / Q000627:therapeutic use; D005865:Gestational Age; D006784:Hospitals, Teaching / Q000706:statistics & numerical data*; D006801:Humans; D010298:Parity; D012189:Retrospective Studies
chemical_list: D018492:Dopamine Antagonists; D056669:Galactogogues; D004294:Domperidone