Attitudes and experiences of community pharmacists towards paediatric off label prescribing: A prospective study

Derek Stewart, Abdul Rouf, Ailsa Claire Snaith, Kathleen Elliott, Peter Joseph Benedict Helms, James Stuart McLay

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31 Citations (Scopus)


AIM: To identify community pharmacist experiences of, and attitudes towards paediatric off-label prescribing. METHODS: A prospective questionnaire-based study, with a 21-item questionnaire issued to 1500 randomly selected community pharmacies throughout the UK during 2005 on three separate occasions. RESULTS: Four hundred and eighty-two (32.1%) completed questionnaires were returned. Over 70% of respondents were familiar with the concept of off-label prescribing, primarily through dispensing experience rather than education, although only 40% were aware of having dispensed a paediatric off-label prescription within the previous month. The reasons given for a prescription being off label were younger age than recommended (84.6%, 297/351), primarily for antihistamines, analgesics and beta(2)-agonists, and higher (73.9%, 229/310) or lower than (41%, 103/258) recommended dose, primarily antibiotics and analgesics. Over 60% of respondents had been asked by the public to sell paediatric over-the-counter medicines, such as antihistamines, analgesics and steroid preparations for off-label use. The majority of respondents used the British National Formulary or the Pack Insert rather than specialist formularies or guidelines as a source of specialist paediatric information. Although 78% of respondents believed they had a responsibility to inform the prescriber that a medicine was off label, only 66% believed that they had a similar responsibility to inform parents. CONCLUSION: The community pharmacists who responded to this questionnaire appear to be aware of and concerned by the issues which surround paediatric off-label prescribing. Despite this, most gained relevant knowledge through work experience rather than undergraduate or postgraduate training or professional development.
Original languageEnglish
Pages (from-to)90-95
Number of pages6
JournalBritish Journal of Clinical Pharmacology
Issue number1
Early online date23 Feb 2007
Publication statusPublished - Jul 2007


  • attitudes
  • community pharmacy
  • off-label prescribing
  • paediatrics
  • questionnaire
  • survey
  • adverse drug-reactions
  • children
  • wards


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