Prevalence of prescription medication use in preschool-age children seen in pediatric otolaryngology

Objective: To examine the prevalence of daily medication use and prescribing patterns in preschool aged children presenting to otolaryngology clinics. Study design: Retrospective summary of prescription-related data from PEDSnet database of two tertiary care children's hospitals within single health system. Methods: All new patients between birth and 5 years of age seen in otolaryngology clinics from October 1, 2016 through September 30, 2017 were included. Existing diagnoses, active prescriptions at time of visit, prescription dates, and demographics were abstracted. Summary analysis was performed on medication prevalence, quantity and duration of use, comparing all variables between age, gender, and geographical regions. Results: Of 7532 patient encounters, 20% presented with active daily medication use. Eustachian tube dysfunction and otitis media were the most common diagnoses regardless of daily medication usage. Corticosteroids, specifically hydrocortisone (Delaware) and Flovent (Florida), were the most common medication prescribed. The number of medications strongly correlated with the number of encounter diagnoses. Overall, patients in Delaware were 4.5 times more likely to have at least one prescription prior to encounter (p < 0.05, 95% CI 3.2–4.8). This pattern was preserved across age and gender. Patients with medication in Delaware and Florida had a median of 2 (IQR 3.0–1.0) and 1 prescriptions (IQR 2.0–1.0), respectively (p < 0.001). There were no differences based on insurance type and no correlations between medication count and age or gender. Conclusion: Children in Delaware presented to otolaryngology clinics with significantly more prescribed medications than in Florida. Regional differences were consistent across age and gender. Most children were on these medications for a significant duration.