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Thursday, 29 August, 2002, 04:13 GMT 05:13 UK
Children 'given inadequate pain relief'
Child with doctor preparing medicine in background
Doctors may be over-cautious on pain relief
Many children do not receive adequate pain relief because they are treated with medicines that have not been tested on young people, it has been suggested.

James McElnay, professor of pharmacy at Queen's University Belfast, has just completed a major research project into paediatric prescribing.

The three-and-half-year study, funded by the charity Action Research, analysed more than 1,000 blood samples collected from 500 babies and children.

It found that 42% of young patients were still suffering moderate pain after being given a post-operative painkiller, and in 1.3% the pain was recorded as severe.


Doctors are left to guess appropriate dosages

Andy Love MP
Professor McElnay said there was also a general lack of the anticipated side-effects.

He said that begged the question as to whether the dosage of the painkiller could have been increased without risk to the patients.

He said the doses selected by clinicians in the study were on the whole appropriate and safe, but the control of symptoms, especially pain, were questionable.

'Not little adults'

"This could mean doctors are erring on the side of caution," he said.

"The time has come for doctors to be armed with the confidence of evidence-based guidelines. Children are not merely little adults."


We should never be in the hazardous situation where prescribing drugs for children and babies is based on assumption or even worse, guesswork

Action Research
The research, which is part of an ongoing programme, also involved the Royal Hospital for Sick Children in Belfast and Liverpool's Alder Hey Children's Hospital.

Any new drug must undergo extensive testing before being used in adults, but there is currently no obligation for separate trials for children.

Many medicines currently prescribed for children do not have a dosage approved by the Medicines Control Agency.

Doctors are thus forced to rely solely on their knowledge or anecdotal evidence when prescribing.

Children and babies handle and absorb drugs differently because their liver and kidneys are less developed.

It has been estimated that 90% of babies and 66% of children being treated in hospital are prescribed drugs that are unlicensed or licensed only for use in adults.

EU study

Action Research chief executive Simon Moore said: "We should never be in the hazardous situation where prescribing drugs for children and babies is based on assumption or even worse, guesswork."

Andy Love, Labour MP for Edmonton, said: "This study confirms what we have known for some time - that children are not getting a fair deal when it comes to medical treatment.

"The quality of medical care that children receive is just as important as that for adults, yet doctors are left to guess appropriate dosages.

"We need a licensing system that gives doctors the information they need so that children can get the best possible treatment."

The issue of paediatric prescribing is being investigated at European Commission level, with a consultation document produced in February 2002.

See also:

20 Nov 00 | Health
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