{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T17:48:30Z","timestamp":1790790510009,"version":"4.1.0"},"reference-count":49,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T00:00:00Z","timestamp":1543363200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004752","name":"State Government of Victoria","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004752","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["1136222"],"award-info":[{"award-number":["1136222"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["607351"],"award-info":[{"award-number":["607351"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Paediatrics Child Health"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Aim<\/jats:title><jats:p>To quantify (i) indicated versus non\u2010indicated prescribing of acid\u2010suppression therapies (AST) in a tertiary paediatric hospital; (ii) patient, provider and hospital factors associated with non\u2010indicated prescribing; and (iii) medication costs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a prospective, electronic medical audit conducted at The Royal Children's Hospital (RCH) Melbourne in August\u2013September 2016. Proton pump inhibitor (PPI) and histamine\u20102 receptor antagonist (H<jats:sub>2<\/jats:sub>RA) prescriptions were extracted, with relevant patient, provider and hospital data. Logistic regression analysis of variables associated with indicated and non\u2010indicated prescribing was undertaken. Costs of indicated and non\u2010indicated prescriptions were estimated, with annual costs projected.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was more non\u2010indicated than indicated prescribing across inpatient, outpatient and emergency department settings. Of the total 303 prescriptions analysed, 238 (78.5%) were non\u2010indicated. Gastrostomy presence (odds ratio (OR) 5.51 (1.96\u201315.46), <jats:italic>P<\/jats:italic> = 0.001), consultant providers (OR 2.69 (1.23\u20135.87), <jats:italic>P<\/jats:italic> = 0.01) and inpatient setting (OR 2.35 (1.16\u20134.77), <jats:italic>P<\/jats:italic> = 0.02) were all associated with a higher likelihood of non\u2010indicated prescribing. The child having a predisposing diagnosis was significantly associated with indicated prescribing (OR 0.41 (0.21\u20130.80), <jats:italic>P<\/jats:italic> = 0.009). A total of 75% of hospital and patient spending was for non\u2010indicated prescriptions. Annual costs of non\u2010indicated AST for Melbourne's RCH were projected to be $15\u2009493.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Non\u2010indicated acid\u2010suppression prescribing is common in a tertiary paediatric hospital and associated with gastrostomy presence, consultant providers and inpatient status. Future research should use qualitative methods to understand clinician and patient drivers of prescribing and use this information to develop and test targeted solutions to reduce non\u2010indicated AST prescribing.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jpc.14287","type":"journal-article","created":{"date-parts":[[2018,11,28]],"date-time":"2018-11-28T16:23:27Z","timestamp":1543422207000},"page":"762-771","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non\u2010indicated acid\u2010suppression prescribing in a tertiary paediatric hospital: An audit and costing study"],"prefix":"10.1111","volume":"55","author":[{"given":"Suzi","family":"Riess","sequence":"first","affiliation":[{"name":"Centre for Community Child Health Royal Children's Hospital  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaoke","family":"Lei","sequence":"additional","affiliation":[{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Li","family":"Huang","sequence":"additional","affiliation":[{"name":"Health Economics Unit, Centre for Health Policy, Melbourne School of Population and Global Health  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel","family":"O'Loughlin","sequence":"additional","affiliation":[{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harriet","family":"Hiscock","sequence":"additional","affiliation":[{"name":"Centre for Community Child Health Royal Children's Hospital  Melbourne Victoria Australia"},{"name":"Health Services Murdoch Children's Research Institute  Melbourne Victoria Australia"},{"name":"Department of Paediatrics, Melbourne University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,11,28]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2014-1778"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.0162"},{"key":"e_1_2_7_4_1","unstructured":"ABIM Foundation.Choosing Wisely: An Initiative of the ABIM Foundation. 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