Reducing unnecessary prescribing in infant reflux

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Our new clinician education and parent/ caregiver information resources target unnecessary prescribing. Together with The Royal Children’s Hospital, we:

• worked with three Victorian hospitals to understand why acid suppression therapy (AST) continues to be unnecessarily prescribed to infants with gastro-oesophageal reflux
• co-developed the resources with clinicians and consumer representatives
• piloted the materials at three Victorian hospitals.

As a result of the pilot, we saw:

• 21 per cent reduction in AST prescribing in infants
• 46 per cent increase in clinicians advising parents to cease ASTs in infants
• 19 per cent increase in parents recognising that ASTs can cause harm in infants.

Summary

Gastro-oesophageal reflux is common in infants but is often misdiagnosed and treated unnecessarily with acid suppression therapy (AST) which can cause harm.

Prior to the pilot project commencing, we found that:

• 52 per cent of parents surveys reported their infant was prescribed an AST;
• parents and clinicians had a poor understanding that ASTs can cause harm in infants and could not identify specific harms;
• 67 per cent believed that AST medications had benefits for infants; and
• Clinician confidence and capability to manage infants with gastro-oesophageal reflux or discuss potential harms and benefits of ASTs with parents varied.

We piloted a number of resources and educational materials at three Victorian hospitals aimed at improving parent and clinician knowledge, and to increase the resources available to parents to support informed decision-making.

To measure the impact of these resources, we repeated surveys with parents and clinicians.

Outcomes

• Reduced prescribing of AST in infants across three Victorian hospitals
• Increase in clinicians advising parents to cease ASTs in infants.
• Increase in parents recognising that ASTs can cause harm in infants.