Information sources for prescribing three groups of supplementary medicines for paediatric patients with cancer in Scottish paediatric oncology wards: a document analysis study

Introduction: The use of medicines for emesis, tumour lysis syndrome, and Pneumocystis pneumonia (PCP) prophylaxis is common in paediatric patients with cancer. Little is known about the available information sources, and their content, to support prescribing decisions for these aforementioned indications in Scotland.
Aims/Objectives: The study aimed to identify the documents available to support prescribing for paediatric patients with cancer for the indications of interest, and to assess their medicine-relevant content.
Methods: Documents were retrieved through conducting a search on commonly used web browsers and contacting National Health Service (NHS) practitioners to collect additional documents. The characterisation of documents was conducted by document and content analysis. Information on eleven medicine-relevant aspects, such as dose regimen, was reviewed for each medicine.
Results: In total, 20 documents were identified: international (n=2), national (n=11), and regional (n=7). Whereas twelve sources were designed for both adults and children, eight were paediatric- specific sources (paediatric cancer-specific (n=6) and paediatric-specific (n=2)). The most informative source for the three indications was the summary of product characteristics (SmPC). Clinical knowledge summaries (CKS) presented no paediatric-specific content to guide the prescribing process for the three indications. The British National Formulary (BNF), in particular, showed a lack of information on specific medicines for the three indications. The most mentioned content in all documents was the dose of medicines. Information on the response to toxicity and drug storage was mostly provided by SmPC. Variation was mostly apparent among information sources for emesis management.
Discussion/Conclusion: The results showed a variety of sources that might guide the prescribing process. Any single information source might not provide all needed information for prescribing. The lack of paediatric-specific evidence for certain medicines might explain the insufficiency of paediatric-specific information in certain sources.
Future investigations might be beneficial to explore the way in which these sources influence prescribers to prescribe medicines.