Knowledge and attitude about off-label prescription of drugs amongst healthcare students and professionals: A cross-sectional questionnaire based study

Authors

Dr. Nidhi H. Vadhavekar , Dr. Anant Patil , Dr. Manu Pandya , Yuvraj Sawant , Rishi Rajesh Sharma Author

Keywords:

Off-label use, prescription, knowledge, adverse drug events

Abstract

Introduction: Off-label drug use (OLDU) is use of drugs outside of its licensed
indication with respect to dose, age, indication and route of administration. OLDU is
often due to lack of effective alternatives or exhaustion of approved drugs in certain
cases. Objective: To analyze the knowledge, awareness and perceptions regarding
OLDU amongst those medical students. Methodology: This questionnaire-based
study was conducted amongst the healthcare professionals and medical students in a
healthcare university, after obtaining ethical clearance. Second year to final year
students from MBBS, dental, nursing, occupational therapy, physiotherapy, allied
health sciences, postgraduates, recent MBBS graduates (passed last year) and
healthcare practitioners who were willing to participate in the study were included. A
total of 18 questions were asked in the English language and the answers were
recorded. Results: Out of 123 respondents, 102 (82.92%) belonged to the MBBS
stream. A total of 101 (82.1%) participants thought that they were aware of the term
“off- label use” in medicine. Sixty-five (52.8%) participants were fully aware of the
definition of OLDU. According to 52 (42.28%), the main cause of a rise in OLDU is
the use of drugs in a condition with similar symptoms. Ninety (73.17%) stated that
keeping updated knowledge regarding a medicine’s approved indication and taking
informed consent after explaining the correct reason behind prescribing off label are
important measures to minimize the misuse of OLDU. Conclusion: Although most
of the participants claimed that they were fully aware of the definition of OLDU, not
all of them could answer the definition correctly. According to most of the
participants, the main cause of a rise in the number of doctors prescribing off-label is
the use of drugs for an indication that is symptomatically similar to the labeled
indication.