Parental awareness, attitudes and decision-making of off-label use in children: a systematic review and meta-analysis.
BMJ Paediatr OpenSep 24, 2026 (epub)
Clinical ResearchPediatrics
Tingyu Cao, Yujing Fei, Rong Jiang et al.
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In 30 seconds
This systematic review and meta-analysis evaluated parental awareness and attitudes towards off-label medication use in children. In seven studies, the pooled parental awareness rate was found to be 20.2%. The analysis highlighted low unconditional acceptance rates and a refusal rate of 36.5%, indicating significant challenges in informed consent and communication between physicians and parents.
Key findings
- Pooled parental awareness rate was 20.2% (95% CI: 10.6% to 31.9%).
- Refusal rate for off-label use was 36.5% (95% CI: 14.6% to 61.8%).
- Conditional acceptance rates varied from 20.6% to 85.1% due to inconsistent definitions.
- Unconditional acceptance rates were reported as 18.2% and 22.7% in two studies.
Why it matters
Understanding parental awareness and attitudes towards off-label medication use is crucial for improving informed consent processes. Enhanced communication can foster trust and better decision-making in pediatric care.