Extent and nature of unlicensed and off-label medicine use in hospitalised children in Palestine

Objective of the study To determine the extent and nature of unlicensed/off-label prescribing patterns in hospitalised children in Palestine. Setting Four paediatric wards in two public health system hospitals in Palestine [Caritas children’s hospital (Medical and neonatal intensive care units) and Rafidia general hospital (Medical and surgical units)]. Method A prospective survey of drugs administered to infants and children <18 years old was carried out over a five-week period in the four paediatric wards. Main outcome measure Drug-licensing status of all prescriptions was determined according to the Palestinian Registered Product List and the Physician’s Desk Reference. Results Overall, 917 drug prescriptions were administered to 387children. Of all drug prescriptions, 528 (57.5%) were licensed for use in children; 65 (7.1%) were unlicensed; and 324 (35.3%) were used off-label. Of all children, 49.6% received off-label prescriptions, 10.1% received unlicensed medications and 8.2% received both. Seventy-two percent of off-label drugs and 66% of unlicensed drugs were prescribed for children <2 years. Multivariate analysis showed that patients who were admitted to the neonatal intensive care unit and infants aged 0–1 years were most likely to receive a greater number of off-label or unlicensed medications (OR 1.80; 95% CI 1.03–3.59 and OR 1.99; 95% CI 0.88–3.73, respectively). Conclusion The present findings confirmed the elevated prevalence of unlicensed and off-label paediatric drugs use in Palestine and strongly support the need to perform well designed clinical studies in children.

Industry–academic links:a new phase in Ireland’s FDI-led industrialisation strategy

We analyse industry–academic links in the context of a dual economy (or disarticulated industrial structure) in Ireland, as an example of a peripheral territory in the EU. The duality found in the Irish industrial structure is the result of a FDI-led industrialisation strategy which has resulted in two distinct economic sectors – foreign and indigenous, respectively – with weak interactions between the two. Through increased public funding of academic research, the Irish government aimed to attract and embed new waves of higher-value foreign direct investment and increase the dynamism of its indigenous enterprise base. Based on a combination of quantitative and qualitative data, the paper analyses a crucial aspect of Ireland’s recent emphasis on STI policy – industry-academic linkages – and finds that the measures introduced reproduce in the public research system the uneven development found in Ireland’s productive system between indigenous industry and the foreign-owned industrial base.