title: Prevalence of Chronic Metoclopramide Use and Associated Diagnoses in the US Pediatric Population.
abstract: OBJECTIVE
  Metoclopramide is the only medication widely used to promote gastrointestinal motility in the USA. Despite its appreciable risk of central nervous system complications, it continues to be prescribed to children for chronic use. We sought to estimate the prevalence of chronic metoclopramide use among US children and identify the diagnoses that may have prompted this use. The US metoclopramide label lists only two indications in adults: symptomatic gastroesophageal reflux (GERD) and diabetic gastroparesis. The latter is rare in children so, in examining the indications likely to have prompted chronic metoclopramide use, we focused on GERD.
  
  
  METHODS
  From two health services databases representing privately and publically insured children, respectively, we estimated the number of US children who used metoclopramide chronically and identified the diagnoses recorded at approximately the time when the chronic use began. We defined chronic use liberally as ≥ 35 days' supply, or conservatively as ≥ 130 days' supply in a 6-month period. For each chronic-use definition, insurance type, and age group, we estimated the proportion of children using metoclopramide chronically. We applied these proportions to US population estimates.
  
  
  RESULTS
  Under the liberal and conservative definitions, respectively, 89,020 and 28,222 US children used metoclopramide chronically.
  
  
  CONCLUSIONS
  In spite of its risk, substantial numbers of US children use metoclopramide chronically for symptoms suggestive of GERD.
authors.affiliation: Epidemiology, Janssen Research and Development LLC, 1125 Trenton-Harbourton Rd, Titusville, NJ, 08560, USA, rweinst1@its.jnj.com.
authors.forename: Rachel B
authors.initials: RB
authors.lastname: Weinstein
authors.forename: Daniel
authors.initials: D
authors.lastname: Fife
authors.forename: Sheldon
authors.initials: S
authors.lastname: Sloan
authors.forename: Erica A
authors.initials: EA
authors.lastname: Voss
authors.forename: William
authors.initials: W
authors.lastname: Treem
mesh_terms: D002648:Child; D005764:Gastroesophageal Reflux / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008787:Metoclopramide / Q000627:therapeutic use*; D010372:Pediatrics; D015995:Prevalence; D014481:United States
chemical_list: D008787:Metoclopramide