Variation in oral liquid medicine concentrations dispensed to children and adults in primary care in England

AIMS: The study aims to characterize the variability in concentrations of oral liquid medicines (OLMs) dispensed in primary care in England. METHODS: Data detailing all liquid medicines dispensed in primary care in England from February 2019 to January 2020, stratified by age into children (<18 years) and adults (≥18 years), were obtained from the NHS Business Services Authority. For each drug licensing status, the number of prescription items and unique concentrations were examined. For each age group, the 30 drugs most commonly dispensed at multiple concentrations, representing over 50% of prescriptions, were analysed and summarized using descriptive statistics. RESULTS: Of the 44.2 million OLM prescription items, 42% were for children. Adjusted for relative sizes of the two populations, children were 2.5 times more likely to be dispensed an OLM than an adult. Children received 294 unique drugs and adults 319. Of the drugs dispensed, 51.4% and 49.2% were supplied in multiple concentrations to children (median 3; range 2-13) and adults (median 3; range 2-11), respectively. Approximately 0.9% of prescription items dispensed to children were unlicensed, and 0.29% for adults, indicating that children were three times more likely to receive an unlicensed product. CONCLUSIONS: OLMs are widely used in adults and children, although an individual child is more likely to receive an OLM than an individual adult. The availability of multiple OLM concentrations per drug is common, for both licensed and unlicensed products. Rationalization could be beneficial.