Author:
Meng Min,Liu Enmei,Zhang Bo,Lu Quan,Zhang Xiaobo,Ge Bin,Wu Ye,Wang Li,Wang Mo,Luo Zhengxiu,Hua Ziyu,Wang Xiaoling,Zhao Wei,Zheng Yi,Wu Xinan,Zhao Ruiling,Meng Wenbo,Xiang Li,Wang Gang,Jia Yuntao,Chen Yongchuan,Dong Xiaoyan,Hao Lina,Liu Chengjun,Lv Meng,Luo Xufei,Liu Yunlan,Shen Quan,Lei Wenjuan,Wang Ping,Sun Yajia,Zhang Juanjuan,Wang Ling,Lei Ruobing,Hou Tianchun,Yang Bo,Li Qiu,Chen Yaolong
Abstract
Abstract
Background
The "Law on Doctors of the People's Republic of China," which was officially implemented on March 1, 2022, emphasizes the requirements for rational drug use and the necessity for appropriate management of off-label drug use. The safety and ethical considerations related to off-label drug use are different in children than in adults. There is so far no management guideline for pediatric off-label use of drugs in China, and the applicability of foreign guidelines is limited. Establishing a localized evidence-based management guideline for pediatric off-label use of drugs to support the national legislation and clinical practice is of critical importance.
Methods
We established a guideline working group, including experts from a broad range of disciplines and developed recommendations following the guidance of the World Health Organization Handbook and the Chinese Medical Association. The following themes were identified by questionnaires and expert interviews to be of great concern in the management of off-label drug use in children: general principles and characteristics of management of pediatric off-label drug use; establishment of expert committees; evidence evaluation; risk–benefit assessment; informed consent; monitoring and assessment of the risk; and monitoring and patient education. Two rounds of Delphi surveys were organized to determine the final recommendations of this guideline. We graded the recommendations based on the body of evidence, referring to the evaluation tool of the Evidence-based management (EBMgt) and the Oxford Center for Evidence-Based Medicine: Level of Evidence (March 2009).
Results
We developed the first guideline for the management of pediatric off-label use of drugs in China.
Conclusions
The guideline is to offer guidance for pediatricians, pharmacists, medical managers, policymakers, and primary care physicians on how to manage off-label drug use in pediatrics and to provide recommendations for Chinese healthcare policy in the future.
Publisher
Springer Science and Business Media LLC
Subject
Pediatrics, Perinatology and Child Health
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