Prescription pattern of drugs in pediatric cancer patients in a tertiary care hospital: An observational study

Abstract

Aims: The objective of the current study was to evaluate prescription pattern and to assess off-label use of drugs used in treatment of pediatric cancer patients. Subjects and Methods: This was a cross-sectional, observational study where patients who presented to the hemato-oncology and solid tumors Outpatient department at a tertiary cancer care hospital were prospectively recruited. Patients of either gender or age between 3 months and 15 years diagnosed with cancer and who has received treatment for at least 6-week duration were included. Demographic details, diagnosis, medication details, and off-label use were analyzed. Prescribing indicators and off-label use were analyzed by descriptive statistics using Microsoft Excel version 2019. Results: Of 300 patients recruited, 67% were male and 33% were female, with a median age of 75 months (interquartile range: 42–129 months). One hundred and seventy-one (57%) patients suffered from hematological cancers, while those having solid tumors were 129 (43%). Most common hematological cancer was found to be acute lymphoblastic leukemia – 126/171 (73.68%) and among 129 solid tumor patients, the most common cancer was found to be Ewing's sarcoma (29). A total number of 944 drugs were prescribed in 300 prescriptions studied. Out of 944 drugs prescribed, 346 (36.65%) were anticancer drugs and 598 (63.35%) were concomitant drugs. Most common anticancer drug prescribed in hematologic cancer was found to be vincristine (60/270), and in solid tumors also, it was vincristine in 24/76. Off-label prescriptions were found mainly in solid tumors in 80.26% (61 out of 76 anticancer drugs), whereas for hematological cancers, it was 3.33% only. The most common drug use off label in solid tumors was Cyclophosphamide. Conclusions: The study reflects the general pattern of drugs used in the treatment of various pediatric cancers and the extent of unavailability of chemotherapeutic agents – more so in the solid tumors' treatment.