Observational Health Data Sciences and Informatics

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====== Drug Utilization in Children  ======

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** Background **
There is a lack of evidence regarding the safety and efficacy of drugs used in children. Most drugs prescribed to children are the same as those originally developed for adults, and are often prescribed simply by extrapolating evidence for adults. Diseases in children, however, might be different from their adult equivalents, and the process underlying growth and development might lead to a different effect or an adverse drug reaction unseen in adults. 

Observational data in the form of electronic health records and insurance claims data have the potential to fill this knowledge gap through retrospective analysis of drug exposure in children and its consequences. A first step is to make an inventory of the drugs taken by children, and the prevalences with which they are prescribed. Previous research in Europe has shown large differences in prescribing patterns between countries, making it difficult to generalize to other countries, let alone other regions. In this study we want to focus on pediatric drug use specifically in Asia.

** Objective **

We aim to measure the prevalence of drug use in children in several countries in Asia. We will compute prevalence for all drugs captured in the databases in the pediatric population. The main analysis will focus on drug classes (anatomical and therapeutic) and these prevalences will be stratified by year to evaluate temporal trends. A secondary analysis will report the five top ingredients per anatomical class per country. All analysis will be stratified by age (< 2 years, 2-11 years, and 12-18 years), and by setting (inpatient or ambulatory care).


**Project Lead(s):** Ian Wong, Martijn Schuemie

**Coordinating Institution(s):** University of Hong Kong

** Additional Participants:**  Kenneth Man, Nicole Pratt, Rae Woong Park, Soo-Yeon Cho, Jack Li, Usman Iqbal, Alex Nguyen

**Full Protocol:** [[https://github.com/OHDSI/StudyProtocols/raw/master/DrugsInPeds/extras/OHDSI%20Drug%20Utilization%20in%20Children%20Protocol.docx|Word doc for the protocol]]

**Initial Proposal Date:**  September 8, 2015

**Launch Date:**  October 1, 2015

**Study Closure Date:** TBD

**Results Submission:** [[mailto:schuemie@ohdsi.org|Email]] 

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===== Requirements =====
**CDM:** V4 or V5

**Table Accessed:**  DRUG_EXPOSURE, CONCEPT, CONCEPT_ANCESTOR, OBSERVATION_PERIOD, PERSON, VISIT_OCCURRENCE

**Database Dialects:** SQL Server, Postgres, Oracle, PDW

**Software:** SQL and R 
 
===== Code ===== 
[[https://github.com/OHDSI/StudyProtocols/tree/master/DrugsInPeds|GitHub code for Proposed Study Drug Utilization in Children]]


===== Datasets Run ===== 
  * Ajou University School of Medicine (AUSOM)
  * Hong Kong Clinical Data Analysis and Reporting System (CDARS)
  * Japan Medical Data Center (JMDC)
  * Taiwan’s National Health Insurance Research Database (NHIRD)
  * Australian Pharmaceutical Benefits Scheme (PBS) 10% Sample Data

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