Children

Background: Antibiotics are the most commonly prescribed drugs in children, representing one third of all prescriptions in this population. High rates of antibiotic prescribing are an increasing worldwide concern, in terms of increased antimicrobial resistance and associated burden to health services. Another trend is an increase in the prescription of psycholeptics and psychoanaleptics in children. Most of these medications are prescribed on an off-label basis. However, there is still a lack of paediatric population-based pharmacoepidemiological research. In addition to this, systems-defined medicine review tools are needed to establish criteria in detecting potentially inappropriate prescribing in children

Study Aims: These pharmacoepidemiological studies aim to determine the prevalence and practice variation of prescribing in children and adolescents aged 0 to 15 years. Furthermore, quality of prescribing indicators will be developed for children aged 0 to 16 yrs and applied to national prescribing databases.

Study Objectives:

  1. To determine rates and trends of antibiotic prescribing in Irish children receiving free medical care.
    - Study Design: A retrospective study (2004-2009) in a National Irish population aged ≤ 15 years using the Irish Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database.
    - Progress to date: This study is complete. The overall rates and trends in antibiotic prescribing in Irish children has been assessed and compared to European data (Keogh et al. 2012).
  2. To analyse the pharmacoepidemiological aspects of prescription medications acting on the nervous system in Irish children with a focus on time trends, ‘off-label’ prescriptions and practice variation.
    - Study Design: A retrospective study (2002-2011) in a national Irish population aged ≤ 15 years using the Irish Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database.
    - Progress to date: This study is complete and a paper has been submitted for publication.
  3. To analyse trends in prescribing of antidepressants in a paediatric population in Ireland.
    -Study design: A retrospective study using data from the HSE-PCRS from 2002-2011 in children aged ≤ 15 years.
    -Progress to date: Analysis is complete and a paper is in preparation.
  4. To analyse trends in benzodiazepine prescribing in a paediatric population in Ireland.
    - Study design: A retrospective study using data from the HSE-PCRS from 2002-2011 in children aged ≤ 15 years.
    - Progress to date: Analysis is now complete for this study. A paper has been submitted for publication.
  5. To determine the quality of prescribing in Irish children
    - Study Design: A list of quality of prescribing indicators will be created based on the published literature, guidelines and expert opinion. These will be validated used a Delphi panel and the final list will be applied to children aged≤ 16 years using the Irish Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. The quality indicators will also be applied to a similar database in Northern Ireland and comparisons made between the two countries.
    - Progress to date: A list of quality indicators has been selected based on current literature and guidelines; these have been refined based on the expert opinion of the steering group and will be validated using a Delphi panel in the near future.