‘Sleep tight’ – a centralised system for melatonin prescribing
Abstract
Objective To describe our experience of developing a centralised system for the prescription of melatonin in children. Methods Melatonin is used widely to help initiate sleep in children. A recent randomised controlled trial demonstrated that melatonin brought sleep onset forward by an average of 20 min and prolonged sleep by an average of over 40 min.1 The cost of paediatric melatonin prescriptions in our Trust April – November 2010 was £231 236.38. (Extrapolated annual spend £462 472.76). As a part of our cost improvement processes, prescribing practices and charges were reviewed. The cost of melatonin to us from ‘community prescriptions’ (FP10) varied widely depending on the individual pharmacy charge, the formulation prescribed and brand of melatonin dispensed. There was no standard quality control process. Hospital pharmacists and clinicians produced a guideline for the prescription of melatonin in paediatric patients, rationalising the formulations and preparations available. Families were informed that melatonin would be prescribed only from the hospital pharmacy. Results Families have been very co-operative with the new procedures. Issues arose in the first few weeks due to a significant shortage of melatonin in stock relative to the amounts of melatonin being prescribed. One batch of melatonin 3 mg MR capsules (imported from the USA) contained 5.6 mg of melatonin. This product is not required to meet pharmacopeial standards and, unlike melatonin capsules supplied…
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