Peer-reviewed article
Prescribing patterns and appropriateness of dietary supplements in pediatric outpatients by age, nutritional status, and clinical diagnoses.
Em Canh Pham, Tuong Vi Thi Le, Tuoi Thi Hong Do, Thanh Chi Le, Hien Duc Le et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001A cross-sectional study of 1,000 Vietnamese children examined how dietary supplements are prescribed in outpatient settings. Single supplements (mainly probiotics) were most common, while multiple supplements together were used in about one-third of cases. The study found that age-appropriate prescribing was high, but dosage accuracy was lower, and underweight children received fewer supplements than evidence suggests they need. The findings reveal gaps in addressing nutritional needs, particularly for children who need growth support.
Key points
- Probiotics and multivitamin-mineral-amino acid complexes were the most frequently prescribed dietary supplements, driven by respiratory and infectious disease diagnoses
- Single-supplement therapy dominated (69.0%), particularly in children aged 1-10 years, while multi-supplement regimens (31.0%) were common in mid-childhood but posed dosing challenges
- Age appropriateness of prescribing was very high (99.1%), but dosage compliance was lower at 91.0%, with 9.0% of prescriptions exceeding recommended doses
- Underweight children received minimal dietary supplements despite evidence supporting multi-nutrient interventions for growth recovery
- Complex supplement regimens and digestive disease diagnoses were significant predictors of non-compliance with prescribed dosages
Limitations
This cross-sectional study captures prescribing patterns at a single point in time in Vietnam and cannot determine whether observed practices improved child health outcomes or explain the clinical reasoning behind prescribing decisions. The study does not evaluate actual adherence by families or follow-up outcomes.
Abstract
OBJECTIVES: Dietary supplements (DS) are increasingly used in pediatric care to address nutritional deficiencies and support treatment, yet their prescribing patterns in low- and middle-income settings are understudied. The aim of this study was to characterize patterns of pediatric DS use and to evaluate the appropriateness of prescribing practices. METHODS: A 2024 cross-sectional study of 1000 Vietnamese pediatric outpatients examined DS use by age, nutritional status, and disease, and assessed age and dosage adherence. RESULTS: Monotherapy dominated (69.0%), primarily in children aged 1-10 y (53.1%), with probiotics (20.5%) and multivitamin-mineral-amino acid complexes (8.1%) prevalent, driven by respiratory (58.8%) and infectious diagnoses. Poly-supplementation (31.0%) was common in mid-childhood, with zinc-probiotic combinations (4.8%) addressing multifaceted needs; however, complex regimens posed dosing challenges. Nutritional status revealed conservative prescribing, with underweight children (6.9%) receiving minimal DS despite evidence supporting multi-nutrient interventions for growth recovery. Age appropriateness was high (99.1%), with minor deviations in infants (0.5%) linked to digestive disorders (adjusted OR = 22.90, P = 0.0006). Dosage compliance was lower (91.0%), with 9.0% exceedances, particularly in complex formulations (e.g., 24.8% for multivitamins-minerals-amino acids). Normal-weight children (74.5%) dominated DS use, reflecting demographic proportionality rather than targeted needs, while overweight (18.6%) and underweight groups showed potential underutilization of corrective DS, such as zinc for malnutrition or vitamin D for obesity-related deficits. Logistic regression highlighted prescription multiplicity (dual DS: adjusted OR = 1.85, P = 0.0150; triple DS: adjusted OR = 2.72, P = 0.0226) and digestive diagnoses as key non-compliance predictors. CONCLUSIONS: These findings underscore a probiotic-centric, conservative DS paradigm, with gaps in addressing high-risk groups and dosing accuracy. Enhanced guidelines, clinician training, and electronic prescribing tools are critical to optimize DS efficacy and safety, aligning with evidence-based standards to improve pediatric outcomes in resource-constrained contexts.
Findings the Hub has extracted
Each claim below is labelled by its type of design and links back to this report.
- Intervention
- Standard dietary supplement prescribing practices (probiotics, multivitamins-minerals-amino acids, zinc combinations) in routine outpatient care
- Population
- 1,000 Vietnamese pediatric outpatients examined by age, nutritional status, and clinical diagnosis
Key finding
Age appropriateness of prescribing was 99.1%, with only minor deviations in infants (0.5%)