O036 Melatonin down-scheduling: An exploration of caregiver and pharmacist perspectives towards melatonin use in school-aged children and adolescents

BACKGROUND: Melatonin is a widely used paediatric sleep-aid. Recent regulatory changes in Australia have widened public access to proprietary melatonin products through community pharmacies. Yet little is known about how pharmacists and caregivers have responded to these regulatory changes. This study aims to explore the impact of melatonin down-scheduling on caregivers and pharmacists. METHODS: A mixed-methods study was conducted in a convenience sample of caregivers with school-aged children/adolescents taking melatonin, and community pharmacists/interns. Participants completed an online questionnaire and were given an option to participate in an in-depth semi-structured interview. The interviews were digitally recorded, transcribed verbatim and analysed using the Framework Approach to identify emergent themes. RESULTS: 53 surveys were returned (caregivers, n=41; pharmacists, n=12). Caregivers (mean age=44.5±5.6; 98.0% female) reported moderate carer burden (18.8±6.8 points) and commonly cared for children (mean age=11.7±2.9) with comorbid autism spectrum disorder (n=18;43.9%) and ADHD (n=17;41.5%). Pharmacists (mean age=28.9±9.6; 71.4% female) handled 12.9±12.4 sleep-related enquires/day and received direct requests for melatonin 19.5±15.9 times/week. Preliminary analyses identified three key themes: (1) product cost and formulation availability; (2) differing safety endpoints; and (3) gaps in patient/clinical education. Caregivers and pharmacists highlighted the need for affordable proprietary products with flexible dosing options. The “naturalness” of melatonin was often conflated with long-term safety by caregivers, and lower abuse/misuse potential by pharmacists. Targeted melatonin education resources were needed for both caregivers and pharmacists. CONCLUSION: Findings allude to the need to further refine existing educational, clinical and distribution/supply processes involved around melatonin products used in school-aged children/adolescents.