{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T11:13:24Z","timestamp":1793445204824,"version":"4.5.0"},"reference-count":43,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:00:00Z","timestamp":1715558400000},"content-version":"unspecified","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Chevidence Lab Child & Adolescent Health of Chongqing Medical University's Children's Hospital's Key Project in 2021","award":["LY03007"],"award-info":[{"award-number":["LY03007"]}]},{"name":"Lanzhou Science and Technology Program in 2022","award":["2022-ZD-16"],"award-info":[{"award-number":["2022-ZD-16"]}]},{"name":"Gansu Provincial Hospital Program in 2023","award":["ZX-62000001-2023-267"],"award-info":[{"award-number":["ZX-62000001-2023-267"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,4,19]]},"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the current prevalence and cost of paediatric off-label drug prescriptions in Gansu, China, and the potential influencing factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>The prevalence of off-label prescriptions in paediatrics was evaluated according to the National Medical Products Administration drug instructions in the China Pharmaceutical Reference (China Pharmaceutical Reference, MCDEX) database. The evidence of the prescription was determined by existing clinical practice guidelines and the Thomson Grade in the Micromedex 2021 compendium. We used logistic regression to investigate the characteristics that influence paediatric off-label drug use after single-factor regression analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A multicentre cross-sectional study of outpatient paediatric prescriptions in 196 secondary and tertiary hospitals in Gansu Province, China, in March and September 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We retrieved 104\u2009029 paediatric prescriptions, of which 39\u2009480 (38.0%) contained off-label use. The most common diseases treated by off-label drugs were respiratory system diseases (n=15\u2009831, 40.1%). A quarter of off-label prescriptions had adequate evidence basis (n=10\u2009130, 25.6%). Unapproved indications were the most common type of off-label drug use (n=25\u2009891, 65.6%). A total of 1177 different drugs were prescribed off-label, with multienzyme tablets being the most common drug (n=1790, 3.5%). The total cost of the prescribed off-label drugs was \u00a5106 116\/day. Off-label prescriptions were less frequent in tertiary than in secondary hospitals. Topical preparations were more commonly prescribed off-label than other types of drugs. Senior-level clinicians prescribed drugs off-label more often than intermediate and junior clinicians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Off-label drug use is widespread in paediatric practice in China. Three-quarters of the prescriptions may potentially include inappropriate medication use, resulting in a daily economic burden of about \u00a581 000 in 2020 in Gansu Province with 25\u2009million inhabitants. The management of off-label drug use in paediatrics in China needs improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2023-078126","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T21:05:18Z","timestamp":1715634318000},"page":"e078126","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Paediatric off-label use of drugs in Gansu, China: a multicentre cross-sectional study"],"prefix":"10.1136","volume":"14","author":[{"given":"Min","family":"Meng","sequence":"first","affiliation":[{"name":"Chevidence Lab Child & Adolescent Health Department, Children's Hospital of Chongqing Medical University, Chongqing, China"},{"name":"National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical 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Pharmacy, Gansu Provincial Hospital, Lanzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yali","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tingji","family":"Shao","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Gansu Provincial Hospital, Lanzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xufei","family":"Luo","sequence":"additional","affiliation":[{"name":"Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, 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