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Attitudes, knowledge and views on off-label prescribing in children among healthcare professionals in Malaysia

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Abstract

Background Off-label prescribing in children is associated with several prerequisites such as ensuring sound and scientific evidence and obtaining written consent prior to use of off-label drugs to ensure that protection is provided to patients and healthcare professionals. Adherence to the pre-requisites depends on the attitude, views and knowledge of the pharmacists and doctors involved in this practice. Objective To explore the attitudes, knowledge and views on off-label prescribing in children among hospital—based pharmacists and paediatric doctors. Setting The study was conducted in a 620-bedded general hospital located in the urban area of central Peninsular Malaysia. Method Face to face, semi-structured interviews with 12 pharmacists and 12 paediatric doctors. Interviews were audio-recorded, transcribed and analysed using constant comparison method. Main outcome measure Themes surrounding hospital—based pharmacists’ and paediatric doctors’ attitude, knowledge and views on off-label prescribing in children. Results Four themes were derived: knowledge on off-label prescribing in children, views on off-label prescribing in children, attitude towards off-label prescribing in children and guidance on off-label prescribing in children. Conclusion There is a need to increase the knowledge of hospital—based pharmacists and paediatric doctors and address several concerns on off-label prescribing in children. The decision to prescribe or dispense off-label drugs involved collective decision-making mechanisms and guidance is required with regards to offlabel prescribing in children.

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Acknowledgements

The authors would like to thank the Director-General of Health Malaysia for permission to publish this paper. The authors would also like to thank the pharmacists and paediatric doctors who took part in this study.

Funding

There is no funding received from any bodies for the conduct of the research.

Conflicts of interest

All authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. School of Pharmaceutical Sciences, Universiti Sains Malaysia, 11800, Penang, Malaysia

    Shamala Balan & Mohamed Azmi Ahmad Hassali

  2. Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia

    Vivienne S. L. Mak

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  1. Shamala Balan
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  2. Mohamed Azmi Ahmad Hassali
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  3. Vivienne S. L. Mak
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Correspondence to Shamala Balan.

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Balan, S., Ahmad Hassali, M.A. & Mak, V.S.L. Attitudes, knowledge and views on off-label prescribing in children among healthcare professionals in Malaysia. Int J Clin Pharm 41, 1074–1084 (2019). https://doi.org/10.1007/s11096-019-00862-y

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