A list of shared drugs for paediatric outpatients: An observational study

Objectives - To identify a list of shared drugs on the basis of those prescribed by a group of paediatricians during the daily clinical practice. The group were involved in initiatives concerning health care for years. Materials and methods - A total of 64 paediatricians operating in 4 local health units (LHUs) of the Lombardy region participated in the study by collecting information about all the pharmacological prescription filled during 8 weeks (April, 2 - June, 1 2012). The percentage of paediatricians prescribing the same drug was calculated for all active substances. Commonly used drugs were included in the list of shared drugs if: they were prescribed by ≥ 50%; ≥ 50% of the prescriptions were filled by recommendation of a specialist and the drug was prescribed by ≥ 25% of the paediatricians. Results - Systemic antibiotics (43.8% of packages), anti-asthmatics (12.9%) and antihistamines (11.8%) were the most prescribed classes. A total of 381 active substances were prescribed. The most prescribed drug was amoxicillin (25.8% of packages), followed by amoxicillin clavulanate (9.2%) and cetirizine (9.0%). About 30% of the prescribed packages were generic and the most prescribed formulation was oral solution (54.6%). The most recommended drug by the specialist was valproic acid. The list of shared drug was composed of 38 active substances belonging to 16 therapeutic subgroups and covering 83.1% of the prescribed packages. Of these drugs, 33 were shared by ≥ 50% of the paediatricians while 5 were mainly recommended by the specialist. Conclusions - A list of shared drugs used during the daily clinical practice was identified on the basis of the frequency of use and sharing among paediatricians. The list could be propaedeutic to the creation of a shared formulary of commonly used paediatric drugs, also taking into account cost-effectiveness and safety in order to improve the rational use of drugs in children.