Children prescribed drugs off-label in one-fifth of physician visits, study finds

Physicians are increasingly prescribing medications off-label to children, with one-fifth of all pediatric physician visits resulting in off-label prescriptions, according to a study published in Pediatrics.

Researchers examined data collected from the CDC's National Ambulatory Medical Care Surveys from 2006 to 2015. The surveys provide information on physician office visits across the U.S. They analyzed an estimated 2 billion office visits.

The researchers studied 141 commonly prescribed drugs and considered their use for conditions other than what they were prescribed for.

They found about 18.5 percent of pediatric visits included an off-label drug order, which equals about 41.2 million off-label orders per year. Among visits with at least one drug order, physicians ordered the drugs off-label in about 83 percent of newborn visits, 49 percent of infant visits and about 40 percent of visits for other ages.

While use of some medications off-label is driven by evidence, "we need this kind of evidence to determine the appropriateness of use of many other drugs currently used off-label to treat a wide range of conditions in children," said Daniel Horton, MD, senior study author and assistant professor of pediatrics and a pediatric rheumatologist at Rutgers Robert Wood Johnson Medical School in New Brunswick, N.J.

Dr. Horton also said that it is not always clear how off-label medications will affect children and they may "may not respond as desired to these drugs and could experience harmful effects."

A 2014 policy statement from the American Academy of Pediatrics noted that off-label drug use is an important public health issue in pediatrics as a large number of drugs do not provide information for use among children on their labels.

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