Back to Journals » Clinical and Experimental Gastroenterology » Volume 4
Trends in utilization and off-label use of polyethylene glycol 4000 laxatives and the prevalence of constipation in children in France
Authors Qizilbash N, Méndez
Published 28 July 2011 Volume 2011:4 Pages 181—188
DOI https://doi.org/10.2147/CEG.S23055
Review by Single anonymous peer review
Peer reviewer comments 4
Nawab Qizilbash1,2, Ignacio Mendez1
1OXON Epidemiology, Madrid, Spain, and London, UK; 2Department of Primary Care and Social Medicine, Imperial College, London University, UK
Purpose: To determine trends in utilization and off-label use of polyethylene glycol (PEG) 4000 in children and to determine the prevalence of constipation.
Methods: Retrospective cross-sectional analyses were conducted from 1997 to 2007 in a French health care database comprising general practitioners and pediatricians. Patients prescribed PEG 4000 (Forlax®; Ipsen Pharma, Paris, France) were used to assess PEG 4000 use; constipation was defined by a diagnosis of constipation or use of any laxative. Analyses used linear regression models to fit trends over time.
Results: The study sample consisted of a nationally representative sample of 1200 general practitioners with 1.6 million patient medical records and 100 pediatricians with 70,000 patient medical records. Data were available from 1997 to 2007 for general practitioners and from 2003 to 2007 for pediatricians and were extrapolated to the national level. Among both groups of physicians there were statistically significant increases in the number of patients prescribed 4 g. For the 10 g dose, there was a decline among pediatricians. The largest increases were in children aged 0–8 years and in females. The prevalence of constipation in children aged 0–18 years was 4%.
Conclusion: There has been an increase in the use of PEG 4000 laxative in children, particularly in the younger ages and in females. Use of the 4 g dose has increased. There was considerable off-label use of PEG 4000 in children aged 0–8 years before the introduction of the 4 g pediatric dose, which reflected clinical need.
Keywords: polyethylene glycol, macrogol 4000, children, drug utilization, database, laxative, off-label use, prevalence, constipation, time trends
© 2011 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.