Decrease in use of contraindicated drugs with automated alerts in children.
BACKGROUND
This study evaluated changes in the use of contraindicated drugs in the pediatric population, via automated alerts through the nationwide drug utilization review.


METHODS
We conducted an interrupted time series analysis using the nationwide health insurance database. Study drugs consisted of a total of 72 drugs in 22 classes that were designated as age contraindicated between January 2007 and December 2011. The subjects consisted of the patients in Korea who had been prescribed with any of the study drugs at least once. Changes in the use of age-contraindicated drugs after the regulatory action were estimated as relative and absolute reductions with 95% CI. Regression analysis was carried out based on the monthly number of users prior to the announcement of age-contraindicated drugs on 3 December 2009 to estimate the predicted values, and these were then compared with the observed values after the announcement.


RESULTS
A total of 2 541 888 patients were prescribed age-contraindicated drugs at least once. The percentage of age-contraindicated drug users was 2.10% of the total users (n = 3 309 566) during the period prior to the 2009 regulatory action, but it decreased to 0.30% (n = 542 529) after the action. Overall, there was an 85.71% relative reduction (95% CI: 71.53-102.72) in the percentage of age-contraindicated drug users. The projected monthly number of users of age-contraindicated drugs showed a gradual downward trend.


CONCLUSIONS
Decreases in contraindicated drugs have accelerated after a regulatory action with automated alerts.
Division of Risk Assessment and International Cooperation, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Inmyung
I
Song
Korea Health Insurance Review and Assessment Service, Review and Assessment Research Institute, Gangwon, Korea.
Han Na
HN
Shin
School of Pharmacy, Sungkyunkwan University, Suwon, Korea.
Ju-Young
JY
Shin
D000293:Adolescent; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D000075203:Contraindications, Drug; D016208:Databases, Factual; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D019983:Guideline Adherence / Q000639:trends*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D050316:Medical Order Entry Systems; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D056910:Republic of Korea
contraindicated drug; drug utilization review; inappropriate drug use; regulatory action