Korean J Clin Pharm.  2015 Dec;25(4):273-279. 10.0000/kjcp.2015.25.4.273.

Prescribing Patterns of Codeine among Children under Aged 12 in Korea

• Park HJ
• Shin HN
• Shin JY

• KMID: 2226421
• DOI: http://doi.org/10.0000/kjcp.2015.25.4.273

Abstract

OBJECTIVE
Codeine may result in death or respiratory depression in children, particularly who are rapid metabolizer of CYP2D6, therefore it should be used cautiously among children under 12 years of age. This study was to investigate the prescribing pattern of codeine among children according to the age group, prescribed diagnosis, type of medical service and medical specialties. METHOD: We used Korea Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) database. Study subjects included inpatients or outpatients, who were prescribed codeine between January, 1, 2011 and December, 31, 2011. Contraindicated use of codeine was defined as the use of codeine at least one times under aged 12. Age groups were sub-classified according to the <2 years, 2-4 years, 5-8 years, and 9-11 years. Frequently prescribed diagnosis (ICD-10), type of medical service, and medical specialties were also described among codeine users under aged 12.
RESULTS
Codeine users were 6,411 inpatients (9,958 prescriptions), and 3,397 outpatients (6,258 prescriptions), respectively. Codeine prescription under 12 years of age were 2.1% (210 prescriptions) among inpatients, and 12.3% (776 prescriptions) among outpatients (p-value<0.05). Outpatient prescriptions of codeine under 12 aged were issued mostly from primary care clinics and frequent diagnosis were unspecified bronchopneumonia (51.6%), and vasomotor rhinitis (23.7%).
CONCLUSION
This study found prescribing of codeine under 12 aged is common in outpatient and primary clinics. Nationwide and community-based efforts should be needed to reduce inappropriate prescribing among children.

Keyword

codeine; children; primary care; physician specialty; drug utilization review

MeSH Terms

Bronchopneumonia
Child*
Codeine*
Cytochrome P-450 CYP2D6
Diagnosis
Drug Utilization Review
Humans
Inappropriate Prescribing
Inpatients
Insurance, Health
Korea*
Outpatients
Prescriptions
Primary Health Care
Respiratory Insufficiency
Rhinitis, Vasomotor
Codeine
Cytochrome P-450 CYP2D6