title: Respiratory drugs prescribed off-label among children in the outpatient clinics of a hospital in Malaysia.
abstract: BACKGROUND
  Prescribing medicines in an unlicensed and off-label manner for children is a widespread practice around the world.
  
  
  OBJECTIVE
  To determine the extent and predictors of off-label respiratory drug prescriptions for children in the outpatient clinics of a hospital in Malaysia.
  
  
  METHODS
  Outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre, a tertiary teaching hospital in Malaysia.
  
  
  METHODS
  The pharmacy-based computer system and medical records of the patients were utilized to collect data from 220 pediatric patients who were prescribed at least one respiratory drug from July 2011 to December 2011.
  
  
  METHODS
  Characteristics of the off-label respiratory drug prescriptions were measured.
  
  
  RESULTS
  A total of 134 children (60.9 %) received at least one respiratory drug prescribed in an off-label manner. The most common reasons for the off-label prescribing of drugs were off-label use by indication (31.5 %), followed by higher than the recommended dose (24.9 %) and lower than the recommended frequency (17.1 %). Diphenhydramine was the most common respiratory drug prescribed off-label. The number of medications prescribed was the only significant predictor of off-label prescription of respiratory drugs. Pediatric patients receiving 4-6 medications were 7.8 times more likely to receive at least one off-label respiratory drug compared to pediatric patients that received 1-3 medications (OR 7.8, 95 % CI 1.74-37.44).
  
  
  CONCLUSIONS
  There was substantial prescribing of respiratory drugs for children in an off-label manner at the outpatient clinics at the Universiti Kebangsaan Malaysia Medical Centre. This highlights the need for more research to be carried out on respiratory drugs in the pediatric population.
authors.affiliation: Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia.
authors.forename: Nurul Fadilah
authors.initials: NF
authors.lastname: Mohamad
authors.forename: Adliah
authors.initials: A
authors.lastname: Mhd Ali
authors.forename: Noraida
authors.initials: N
authors.lastname: Mohamed Shah
mesh_terms: D000293:Adolescent; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D004155:Diphenhydramine / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008171:Lung Diseases / Q000188:drug therapy / Q000453:epidemiology; D008296:Malaysia / Q000453:epidemiology; D008297:Male; D056687:Off-Label Use / Q000592:standards*; D010044:Outpatient Clinics, Hospital / Q000592:standards* / Q000639:trends*; D055553:Prescription Drugs / Q000627:therapeutic use
chemical_list: D018926:Anti-Allergic Agents; D018927:Anti-Asthmatic Agents; D055553:Prescription Drugs; D004155:Diphenhydramine