Prescription Drug

Prescription Drug Use by One Million Canadian Children

Prescribing patterns and conformity with approved uses are features of this large-scale analysis.

Canada's universal healthcare system makes it possible to track prescription medicine use in a large population. Prescription drug use was tabulated for more than one million pediatric claimants -- representing approximately two million eligible children (30% of Canadians younger than 18 years, half of whom did not receive prescriptions).

Four million prescriptions were dispensed to children during the 12-month study period, an average of 3.9 prescriptions each. High use was concentrated among a relatively small proportion: About 26% of these children received more than 72% of all prescriptions. Sixty-three percent received only one or two prescriptions. A wide range of drugs (almost 1400) was prescribed, many outside the age ranges approved by Health Canada and many for which safety and efficacy in children had not been established. Children with serious medical conditions had the same high drug-use patterns as adults with serious conditions.

Antibiotics were dispensed to 76% of children, nearly half of whom received no other drug. Prescriptions varied by age, but amoxicillin was the leading antibiotic at all ages. Seven percent of children received five or more courses of antibiotics in 12 months; younger children were more likely than older children to receive multiple courses and also to receive multiple antibiotic agents at one time. The second most commonly prescribed class was respiratory drugs: 18% of children received at least one prescription for such drugs, short-acting ß₂-agonists and inhaled steroids most frequently.

Analgesics and anti-inflammatories made up 8% of claims. A small proportion of children used psychotropic drugs: 3% received stimulants, 2% antidepressants, and 1% antipsychotics. Sixteen percent of recipients aged 10 to 17 years had at least one prescription for acne therapy. Hormonal contraception was prescribed to 19% of all female claimants aged 11 to 17 years (most of whom were 15 or older). Approximately 1% of children received anticonvulsants. Two percent received at least one gastrointestinal target drug. Approximately 0.3% of children received insulin.