Administration of off-label medicines to paediatrics, self-reported experiences and perceptions of nurses working in paediatric wards in Jordan

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The purpose of this study was to explore perceptions and experiences of nurses working in paediatric wards in Jordan towards the off-label administration of medicines in children.


This is a prospective cross-sectional questionnaire-based study. A validated questionnaire was administered to 200 paediatric nurses in different hospitals in Jordan. The questionnaire was obtained from a previous study conducted to assess the perceptions and attitudes of paediatricians towards off-label medicine use. The questionnaire consisted of 27 questions and was divided into four parts.

Key findings

Only 25.6% of respondents were familiar with the concept of off-label medicine use, primarily through work experience. The most common reasons for that were younger age than recommended (86.6%), and higher than (64%) or lower than (38%) recommended dose. Furthermore, lack of dosage data, risk of side effect and lack of clinical trials data were recognized as major areas of concern for paediatric nurses when handling paediatric off-label medicines. More than half of respondents (55%) believed that the lack of appropriate formulations or the lack of efficacy data were of concern.


The study revealed low levels of knowledge of off-label medicine use in children among nurses. The majority of respondents admitted to unknowingly administer medicines in an off-label manner to paediatrics. The implementation of training programmes and workshops is very important to increase nurses’ awareness of the use of off-label medicine in children. Further development of the educational curriculum for nurses should cover such use of medicine in children. Multidisciplinary paediatric care should be encouraged, specifically the collaboration between nurses and clinical pharmacists.

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