Commonly Used Medicines On Neonatal Units in the UK
Condition: Infant, Newborn; Pharmacoepidemiology; Intensive Care Units, Neonatal
Study type: Observational

Summary: 
      This retrospective analysis of drug utilisation data aims to study the patterns of use of
      medicines in neonatal units in the UK from 2010 to 2017. Prescribing drugs in neonates can be
      complex and the application of pharmacotherapy principles can be challenging due to the lack
      of licenced formulations and limited evidence-base for indications, dosing and/or adverse
      events. A systematic review of drug utilisation pattern in neonatal units in different health
      care settings identified antibiotics, caffeine and vitamin supplements as the most commonly
      used drugs and highlighted that further research is needed to investigate drug utilisation
      and rational use of medicines in neonates. The only UK study included in this systematic
      review and available from our search of literature was conducted in 2009. This survey,
      however, had a low response rate (only 42% units responded) and it included data collection
      over a very short period of 2 weeks and that could limit its generalisability to other NICU
      settings. It identified the need for research in to medicines for neonates and that this
      research agenda should be informed by the extent of medication use in this field. However,
      our literature search revealed that there is very little information on the current patterns
      of medication use in neonates. An updated drug utilisation study is warranted in a neonatal
      setting in UK.
    

Detailed description: 
      The aim of this study is to investigate current and recent patterns of drug utilisation in
      neonatal units in the UK.

      We will conduct a retrospective pharmacoepidemiological study of a large prospectively
      collected database (The National Neonatal Research Database -REC Number 16/LO/1093). The
      study will use de-identified historical data recorded in this database. There is no patient
      recruitment and the project involves no changes to patient care. The data to be used for this
      project are stored in de-identified form.

      Data items will include descriptive, background data to allow for age and gestation at the
      time of drug use and subgroup analysis (such as birth weight, gestational age, clinical
      condition, day of drug use) and data on drug use (name of drug and age at use).
    

Intervention name(s): No intervention
Intervention type(s): Other
Intervention description(s): This is a retrospective, observational pharmacoepidemiological study using nationally collected data. There is no intervention.
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        Inclusion criteria

          -  Infants admitted to neonatal units in England, Scotland, and Wales

          -  Admitted between 01 January 2010 and 31 December 2017.

          -  No limits in gestational age or birth weight.

        Exclusion cirteria

          -  Infants who received all their care in the postnatal ward

          -  Infants who were not admitted to any neonatal unit
      
Keywords: Infants, neonates; rational drug use