Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic
This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psy...
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| Veröffentlicht in: | European child & adolescent psychiatry 2016, Vol.25 (1), p.25-31 |
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| creator | Nielsen, Eva Skovslund Hellfritzsch, Maja Sørensen, Merete Juul Rasmussen, Helle Thomsen, Per Hove Laursen, Torben |
| description | This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05–N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited. |
| doi_str_mv | 10.1007/s00787-015-0699-z |
| format | Article |
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We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05–N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited.</description><identifier>ISSN: 1018-8827</identifier><identifier>EISSN: 1435-165X</identifier><identifier>DOI: 10.1007/s00787-015-0699-z</identifier><identifier>PMID: 25724547</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adolescent ; Adolescents ; Antidepressants ; Attention Deficit Disorder with Hyperactivity - diagnosis ; Attention Deficit Disorder with Hyperactivity - drug therapy ; Attention Deficit Disorder with Hyperactivity - epidemiology ; Attention deficit hyperactivity disorder ; Behavior disorders ; Child ; Child & adolescent psychiatry ; Child and Adolescent Psychiatry ; Children ; Children & youth ; Clinical research ; Clinical trials ; Clinics ; Critical incidents ; Cross-Sectional Studies ; Denmark - epidemiology ; Diabetes ; Drug Prescriptions ; Drugs ; Evidence based ; Female ; Hospitals ; Humans ; Male ; Medical treatment ; Medicine ; Medicine & Public Health ; Melatonin ; Off-label ; Off-Label Use ; Original Contribution ; Outpatient clinics ; Outpatient Clinics, Hospital ; Pediatrics ; Pharmaceutical industry ; Prescribed ; Prescribing ; Prescription drugs ; Psychiatric Department, Hospital ; Psychiatric units ; Psychiatry ; Psychotropic drugs ; Psychotropic Drugs - therapeutic use ; Substance abuse treatment ; Suicides & suicide attempts ; Teenagers</subject><ispartof>European child & adolescent psychiatry, 2016, Vol.25 (1), p.25-31</ispartof><rights>Springer-Verlag Berlin Heidelberg 2015</rights><rights>Springer-Verlag Berlin Heidelberg 2016</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c372t-ddab043bda83526272bf4aae3adf1ea6c09d8e4db132d5f8f06f34563c2285183</citedby><cites>FETCH-LOGICAL-c372t-ddab043bda83526272bf4aae3adf1ea6c09d8e4db132d5f8f06f34563c2285183</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00787-015-0699-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00787-015-0699-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,12825,27901,27902,30976,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25724547$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nielsen, Eva Skovslund</creatorcontrib><creatorcontrib>Hellfritzsch, Maja</creatorcontrib><creatorcontrib>Sørensen, Merete Juul</creatorcontrib><creatorcontrib>Rasmussen, Helle</creatorcontrib><creatorcontrib>Thomsen, Per Hove</creatorcontrib><creatorcontrib>Laursen, Torben</creatorcontrib><title>Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic</title><title>European child & adolescent psychiatry</title><addtitle>Eur Child Adolesc Psychiatry</addtitle><addtitle>Eur Child Adolesc Psychiatry</addtitle><description>This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05–N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited.</description><subject>Adolescent</subject><subject>Adolescents</subject><subject>Antidepressants</subject><subject>Attention Deficit Disorder with Hyperactivity - diagnosis</subject><subject>Attention Deficit Disorder with Hyperactivity - drug therapy</subject><subject>Attention Deficit Disorder with Hyperactivity - epidemiology</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Behavior disorders</subject><subject>Child</subject><subject>Child & adolescent psychiatry</subject><subject>Child and Adolescent Psychiatry</subject><subject>Children</subject><subject>Children & youth</subject><subject>Clinical research</subject><subject>Clinical trials</subject><subject>Clinics</subject><subject>Critical incidents</subject><subject>Cross-Sectional Studies</subject><subject>Denmark - epidemiology</subject><subject>Diabetes</subject><subject>Drug Prescriptions</subject><subject>Drugs</subject><subject>Evidence based</subject><subject>Female</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Medical treatment</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Melatonin</subject><subject>Off-label</subject><subject>Off-Label Use</subject><subject>Original Contribution</subject><subject>Outpatient clinics</subject><subject>Outpatient Clinics, Hospital</subject><subject>Pediatrics</subject><subject>Pharmaceutical industry</subject><subject>Prescribed</subject><subject>Prescribing</subject><subject>Prescription drugs</subject><subject>Psychiatric Department, Hospital</subject><subject>Psychiatric units</subject><subject>Psychiatry</subject><subject>Psychotropic drugs</subject><subject>Psychotropic Drugs - therapeutic use</subject><subject>Substance abuse treatment</subject><subject>Suicides & suicide attempts</subject><subject>Teenagers</subject><issn>1018-8827</issn><issn>1435-165X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNp1kU1rHSEUhiW0JGnaH9BNEbrpxsTP0VmW9CsQyKaB7MTx414vc3WqM4vk18dh0lIKXagHfd7Xw3sAeE_wJcFYXtW2KYkwEQh3fY-eTsA54Uwg0omHV63GRCGlqDwDb2o94Ab2mJ6CMyok5YLLc3C4CwGNZvAjnIqvtsQhph3MAU710e7zXPIULXRl2VUYEzTwi0mx7qHdx9FBk9pyeWxKn-ZNE81cmiQv82TmuF7bMaZo34LXwYzVv3s5L8D9t68_r3-g27vvN9efb5Flks7IOTNgzgZnFBO0o5IOgRvjmXGBeNNZ3DvluRsIo04EFXAXGBcds5QqQRS7AJ8236nkX4uvsz7G1t44muTzUjWRgnHOeyob-vEf9JCXklp3K0VVSwmvFNkoW3KtxQc9lXg05VETrNdB6G0QuuWr10Hop6b58OK8DEfv_ih-J98AugG1PaWdL399_V_XZ8kQlT0</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Nielsen, Eva Skovslund</creator><creator>Hellfritzsch, Maja</creator><creator>Sørensen, Merete Juul</creator><creator>Rasmussen, Helle</creator><creator>Thomsen, Per Hove</creator><creator>Laursen, Torben</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0-V</scope><scope>3V.</scope><scope>7QJ</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>88J</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ALSLI</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>HEHIP</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>M2O</scope><scope>M2R</scope><scope>M2S</scope><scope>MBDVC</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>2016</creationdate><title>Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic</title><author>Nielsen, Eva Skovslund ; Hellfritzsch, Maja ; Sørensen, Merete Juul ; Rasmussen, Helle ; Thomsen, Per Hove ; Laursen, Torben</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c372t-ddab043bda83526272bf4aae3adf1ea6c09d8e4db132d5f8f06f34563c2285183</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adolescents</topic><topic>Antidepressants</topic><topic>Attention Deficit Disorder with Hyperactivity - diagnosis</topic><topic>Attention Deficit Disorder with Hyperactivity - drug therapy</topic><topic>Attention Deficit Disorder with Hyperactivity - epidemiology</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Behavior disorders</topic><topic>Child</topic><topic>Child & adolescent psychiatry</topic><topic>Child and Adolescent Psychiatry</topic><topic>Children</topic><topic>Children & youth</topic><topic>Clinical research</topic><topic>Clinical trials</topic><topic>Clinics</topic><topic>Critical incidents</topic><topic>Cross-Sectional Studies</topic><topic>Denmark - epidemiology</topic><topic>Diabetes</topic><topic>Drug Prescriptions</topic><topic>Drugs</topic><topic>Evidence based</topic><topic>Female</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Male</topic><topic>Medical treatment</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Melatonin</topic><topic>Off-label</topic><topic>Off-Label Use</topic><topic>Original Contribution</topic><topic>Outpatient clinics</topic><topic>Outpatient Clinics, Hospital</topic><topic>Pediatrics</topic><topic>Pharmaceutical industry</topic><topic>Prescribed</topic><topic>Prescribing</topic><topic>Prescription drugs</topic><topic>Psychiatric Department, Hospital</topic><topic>Psychiatric units</topic><topic>Psychiatry</topic><topic>Psychotropic drugs</topic><topic>Psychotropic Drugs - therapeutic use</topic><topic>Substance abuse treatment</topic><topic>Suicides & suicide attempts</topic><topic>Teenagers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nielsen, Eva Skovslund</creatorcontrib><creatorcontrib>Hellfritzsch, Maja</creatorcontrib><creatorcontrib>Sørensen, Merete Juul</creatorcontrib><creatorcontrib>Rasmussen, Helle</creatorcontrib><creatorcontrib>Thomsen, Per Hove</creatorcontrib><creatorcontrib>Laursen, Torben</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Nursing & Allied Health Database</collection><collection>Neurosciences Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Social Science Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>Sociology Collection</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Consumer Health Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest Psychology</collection><collection>Research Library</collection><collection>Social Science Database</collection><collection>Sociology Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>European child & adolescent psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nielsen, Eva Skovslund</au><au>Hellfritzsch, Maja</au><au>Sørensen, Merete Juul</au><au>Rasmussen, Helle</au><au>Thomsen, Per Hove</au><au>Laursen, Torben</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic</atitle><jtitle>European child & adolescent psychiatry</jtitle><stitle>Eur Child Adolesc Psychiatry</stitle><addtitle>Eur Child Adolesc Psychiatry</addtitle><date>2016</date><risdate>2016</risdate><volume>25</volume><issue>1</issue><spage>25</spage><epage>31</epage><pages>25-31</pages><issn>1018-8827</issn><eissn>1435-165X</eissn><abstract>This study aimed to describe the level of off-label treatment with psychotropic drugs at a child and adolescent psychiatric outpatient clinic in Denmark. We performed a cross-sectional study assessing records on patients treated with medicine at two outpatient clinics at the child and adolescent psychiatric ward, on 1 day in 2014. Prescriptions of drugs from ATC group N05–N06 were classified according to label status. Six hundred and fifteen drug prescriptions distributed on nine different drugs were prescribed to 503 children eligible for this study. Overall results showed that 170 of the 615 prescriptions were off-label, which corresponds to 27.6 %. Attention deficit hyperkinetic disorder (ADHD) drugs were prescribed 450 times (73.2 %) of which 11 prescriptions were off-label (2.4 %). Other psychotropic drugs comprised 165 (26.8 %) prescriptions and of these 159 (96.4 %) were off-label. With 106 prescriptions, melatonin was the most prescribed of these drugs; all prescriptions were off-label. The main reasons for classifying prescriptions as off-label were age and indication of treatment. This cross-sectional study reveals that medical treatment of children with other psychotropic drugs than ADHD drugs is usually off-label. ADHD drugs were, as the only drug group, primarily prescribed on-label. Although off-label prescription may be rational and even evidence based, the responsibility in case of, e.g. adverse drug reactions is a challenge, and clinical trials in children should be incited.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>25724547</pmid><doi>10.1007/s00787-015-0699-z</doi><tpages>7</tpages></addata></record> |
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| ispartof | European child & adolescent psychiatry, 2016, Vol.25 (1), p.25-31 |
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| subjects | Adolescent Adolescents Antidepressants Attention Deficit Disorder with Hyperactivity - diagnosis Attention Deficit Disorder with Hyperactivity - drug therapy Attention Deficit Disorder with Hyperactivity - epidemiology Attention deficit hyperactivity disorder Behavior disorders Child Child & adolescent psychiatry Child and Adolescent Psychiatry Children Children & youth Clinical research Clinical trials Clinics Critical incidents Cross-Sectional Studies Denmark - epidemiology Diabetes Drug Prescriptions Drugs Evidence based Female Hospitals Humans Male Medical treatment Medicine Medicine & Public Health Melatonin Off-label Off-Label Use Original Contribution Outpatient clinics Outpatient Clinics, Hospital Pediatrics Pharmaceutical industry Prescribed Prescribing Prescription drugs Psychiatric Department, Hospital Psychiatric units Psychiatry Psychotropic drugs Psychotropic Drugs - therapeutic use Substance abuse treatment Suicides & suicide attempts Teenagers |
| title | Off-label prescribing of psychotropic drugs in a Danish child and adolescent psychiatric outpatient clinic |
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