Decrease in use of contraindicated drugs with automated alerts in children

Background This study aims to evaluate changes in the use of contraindicated drugs with automated alerts through the nationwide drug utilization review in the pediatric population. Methods We conducted an interrupted time series analysis using the nationwide health insurance database. Study drugs were a total of 72 drugs in 22 classes that were designated as age-contraindicated between January 2007 and December 2011. Study subjects consisted of the patients in Korea who had been prescribed with any of the study drugs at least once. Changes in the use of age-contraindicated drugs after the regulatory action were estimated as relative and absolute reductions with 95% confidence intervals (CI). We performed the regression analysis based on the monthly number of users prior to the announcement of age-contraindicated drugs on December 3, 2009 to estimate the predicted values, and they were compared with the observed values after the announcement. Results A total of 2,541,888 patients were prescribed age-contraindicated drugs at least once. The percentage of age-contraindicated drug users was 2.10% of the total users of study drugs (N=3,309,566) during the period prior to the 2009 regulatory action, but it decreased to 0.30% (N=542,529) after the action. Overall, there was an 85.71% relative reduction (95% CI: 71.53%-102.72%) in the percentage of age-contraindicated drug users. The projected monthly numbers of users of age-contraindicated drugs showed a gradual downward trend. Conclusion Decreases in contraindicated drugs have accelerated after a regulatory action with automated alerts. This article is protected by copyright. All rights reserved.