Cost-effectiveness of oral ondansetron for children with acute gastroenteritis in primary care: a randomised controlled trial

Weghorst, Anouk Ah; Holtman, Gea A; Bonvanie, Irma J.; Wolters, Pien I; Kollen, Boudewijn J.; Vermeulen, Karin M.; Berger, Marjolein Y.

doi:10.3399/bjgp.2020.1093

Cited by 5 publications

(4 citation statements)

References 25 publications

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“…In the Netherlands, the recommended single dose of oral ondansetron is 0.1 mg/kg, while Australia advises a higher single dosage regimen [8-15kg 2mg; 15-30kg 4mg; >30kg 6-8mg] [ 19 , 28 ] consistent with previous research [ 29 , 30 ]. The lower dosage strategy in the Netherlands is based on a more recent randomized controlled trial that found [cost-]effectiveness at a lower dosage [ 31 , 32 ]. Furthermore, another study has revealed that children with acute gastroenteritis who received higher doses of ondansetron did not experience a greater reduction in vomiting, nor did they require less intravenous rehydration or hospitalizations compared to children who received lower doses [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis

Weghorst,

Sanci,

Berger

et al. 2024

PLoS ONE

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Background Acute gastroenteritis is a highly contagious disease demanding effective public health and clinical care systems for prevention and early intervention to avoid outbreaks and symptom deterioration. The Netherlands and Australia are both top-performing, high-income countries where general practitioners (GPs) act as healthcare gatekeepers. However, there is a lower annual incidence and per-case costs for childhood gastroenteritis in Australia. Understanding the systems and policies in different countries can lead to improvements in processes and care. Therefore, we aimed to compare public health systems and clinical care for children with acute gastroenteritis in both countries. Methods A cross-country expert study was conducted for the Netherlands and Australia. Using the Health System Performance Assessment framework and discussions within the research group, two questionnaires (public health and clinical care) were developed. Questionnaires were delivered to local experts in the Netherlands and the state of Victoria, Australia. Data synthesis employed a narrative approach with constant comparison. Results In Australia, rotavirus vaccination is implemented in a national program with immunisation requirements and legislation for prevention, which is not the case in the Netherlands. Access to care differs, as Dutch children must visit their regular GP before the hospital, while in Australia, children have multiple options and can go directly to hospital. Funding varies, with the Netherlands providing fully funded healthcare for children, whilst in Australia it depends on which GP (co-payment required or not) and hospital (public or private) they visit. Additionally, the guideline-recommended dosage of the antiemetic ondansetron is lower in the Netherlands. Conclusions Healthcare approaches for managing childhood gastroenteritis differ between the Netherlands and Australia. The lower annual incidence and per-case costs for childhood gastroenteritis in Australia cannot solely be explained by the differences in healthcare system functions. Nevertheless, Australia’s robust public health system, characterized by legislation for vaccinations and quarantine, and the Netherland’s well-established clinical care system, featuring fully funded continuity of care and lower ondansetron dosages, offer opportunities for enhancing healthcare in both countries.

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Section: Discussionmentioning

confidence: 99%

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis

Weghorst,

Sanci,

Berger

et al. 2024

PLoS ONE

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“…The use of different routes of ondansetron administration in children having nausea and vomiting has been studied previously, and it was found that orally disintegrated ondansetron tablet provides an easy and acceptable route of administration. It is non-invasive compared to intravenous ondansetron and hence preferred, especially in children who are eligible to be managed as an out-patient [20] . Our study also shows that orally disintegrated ondansetron is accepted well by children having symptoms of acute gastroenteritis.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Ondansetron in comparison to Domperidone for treating vomiting in acute gastroenteritis among children in a tertiary care hospital setting: A quasi-experimental study

Zafar¹,

Rizwan²,

Rafique³

et al. 2023

J. Univ. Med. Dent. Coll.

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BACKGROUND & OBJECTIVE: There is inconsistent evidence on using antiemetic drugs (ondansetron and domperidone) in children with vomiting associated with gastroenteritis having dehydration. The study's objective was to compare the effectiveness of oral domperidone with ondansetron for treating vomiting during acute gastroenteritis in children with either mild or moderate dehydration. METHODOLOGY: This non-controlled quasi-experimental study was conducted at Allama Iqbal Teaching Hospital, Sialkot, in the department of Pediatrics from 1st October 2019 to 31st December 2019. Sixty children aged 1-12 years having acute gastroenteritis, with mild or moderate dehydration after the failure of initial oral rehydration therapy, were included. Children in-group A (n=30) received a single dose of an orally disintegrating tablet of ondansetron, and children in-group B (n=30) were treated with domperidone. The absence of vomiting for 6 hours and subsequent successful rehydration in these two groups was the primary outcome. The Chi-square test was applied to compare the frequency of primary outcome between the ondansetron and domperidone groups, considering p-value ≤0.05 was considered statistically significant. RESULTS: The mean age of patients was 4.4±1.8 years in group A compared to 5.1±2.7 years in group B. Oral Ondansetron was successful in controlling vomiting in 19(63.4%) patients compared to 11(36.6%) in domperidone group (p=0.39). CONCLUSION: The single dose of oral ondansetron compared to domperidone was significantly effective in controlling the vomiting in-patient with acute gastroenteritis presented with either mild or moderate dehydration, resulting in effective oral rehydration subsequently.

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“…17 As Ondansetron is believed to reduce emesis, it might be directly improving or the oral intake of ORT which further goes on to reduce the need for IV rehydration as well as hospitalization. [18][19][20] The strengths of this study include, being the 1 st study from a resource limited setting of Pakistan comparing efficacy of Domperidone versus…”

Section: Discussionmentioning

confidence: 99%

Comparison of Ondansetron versus Domperidone for treating vomiting in acute gastroenteritis in children at a resource limited setting of South Punjab, Pakistan

Ahmad¹,

Zarafshan²,

Sahar³

2022

Pak J Med Sci

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Objectives: To compare the efficacy of Ondansetron versus Domperidone for treating vomiting in acute gastroenteritis (AGE) in children at a resource limited emergency setting of South Punjab, Pakistan. Methods: This open label randomized controlled trial was conducted at The Pediatric Emergency Department of Tehshil Headquarter Hospital, Liaqatpur, Pakistan, from July 2020 to June 2021. A total of 300 children of both genders aged below 12 years of age having 3 or more non-bilious, non-bloody vomiting episodes within 24 hours and with suggestive signs and symptoms of AGE were enrolled and randomized (150 in each group). Efficacy of both drugs was compared in terms of need of 2nd dose within 15 minutes, cessation of vomiting at 6-hour and 24-hour follow up. Results: Out of a total of 300 children, 162 (54.0%) were male. Mean age was 4.7±2.3 years. Twenty seven (18.0%) children in Ondansetron group required 2nd dose within 15 minutes while 38 (25.3%) children in Domperidone group required the 2nd dose (p=0.1232). Cessation of vomiting at 6-hour interval was noted among 126 (84.0%) children in Ondansetron group in comparison to 118 (78.7%) in Domperidone group (p=0.2359). It was revealed that 127/142 (89.4%) children in Ondansetron group had cessation of vomiting at 24-hours follow up while this was noted to be among 108/134 (80.6%) children in Domperidone group (p=0.0390). Conclusion: In comparison to Domperidone, Ondansetron was found to have better efficacy aiming cessation of AGE associated vomiting among children with mild to moderate dehydration. Clinical Trial Registration: NCT05076461 (www.clinicaltrials.gov). doi: https://doi.org/10.12669/pjms.38.6.5532 How to cite this:Ahmad T, Zarafshan U, Sahar B. Comparison of Ondansetron versus Domperidone for treating vomiting in acute gastroenteritis in children at a resource limited setting of South Punjab, Pakistan. Pak J Med Sci. 2022;38(6):---------. doi: https://doi.org/10.12669/pjms.38.6.5532 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Cost-effectiveness of oral ondansetron for children with acute gastroenteritis in primary care: a randomised controlled trial

Cited by 5 publications

References 25 publications

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis

Comparing healthcare systems between the Netherlands and Australia in management for children with acute gastroenteritis

Effectiveness of Ondansetron in comparison to Domperidone for treating vomiting in acute gastroenteritis among children in a tertiary care hospital setting: A quasi-experimental study

Comparison of Ondansetron versus Domperidone for treating vomiting in acute gastroenteritis in children at a resource limited setting of South Punjab, Pakistan

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