Greater emphasis on off-label prescribing needed
Greater emphasis on dealing with off-label prescribing is needed in pharmacy undergraduate and postgraduate education, say the authors of a study published in the British
Journal of Clinical Pharmacology (2007;64:90).
From 482 questionnaires (out of 1,500 distributed randomly to community
pharmacies in 2005), only two out of five community pharmacists said
that they had dispensed off-label prescriptions for children (under the
age of 12 years) in the preceding month. Nearly half of respondents denied
such dispensing within the past month and 13 per cent were unsure. According
to the authors, such figures suggest “a possible failure to recognise
off-label prescribing when it occurs”.
Most respondents (78 per cent) agreed or strongly agreed that pharmacists
have a responsibility to inform the prescriber when off-label prescribing
of medicines for children occurs. “However,” the authors
point out, “without standard agreed protocols, either party may
see the other as questioning their competence, a situation which may
in part be resolved by the availability of the BNF for Children.”
Two thirds agreed or strongly agreed that pharmacists have a responsibility
to inform parents that their child’s medicine is prescribed off
label.
The authors add: “Surprisingly, only 20 per cent of respondents
believed that a lack of appropriate formulations was a significant issue,
a finding similar to that reported for hospital paediatricians.”
They suggest that pharmacists should aspire to being competent and confident
in recognising and dealing with appropriate off-label and unlicensed
prescribing. The results highlight “a significant deficiency in
current pharmacy undergraduate and postgraduate education”, the
authors assert.
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