Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals

Abstract

PurposeGuidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children.MethodsTwelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated.ResultsA total of 840 cases were reviewed. Both GINA and JPGL revealed that 328 (39.0%) and 249 (29.6%) subjects had intermittent asthma whereas 24 (2.9%) and 21 (2.5%) subjects had severe persistent asthma, respectively. Although higher category controllers tended to be prescribed to those who had more severe asthma, there was much overlap in categories of prescribed controllers between groups with regard to asthma severities. Leukotriene receptor antagonists (LTRA) was the most frequently prescribed as a single controller (40%) or as an add-on medication (19%) in the group of asthmatic children <6 years.ConclusionsKorean children have distinctive patterns of asthma severity and management strategies with a lower prevalence of severe asthma and a preference toward LTRA rather than low dose inhaled corticosteroids (ICS) alone or add-on long-acting beta-agonist (LABA) in the group of <6 year-old asthmatics that has not been predicted in Western countries. Thus, strategies tailored to regional situations need to be developed and recommended.

Parental questionnaires provided reliable data on childhood asthma compared with national registers

“…Maintenance treatment with ICS or LTRA, combined with LABA, became more common with increasing age in our cohort, and this was in line with other studies 26 . Despite this, we found that 38.2% of our cohort only received SABA at 11‐13 years of age and this suggests that clinicians were under prescribing maintenance treatment to this age group.…”

Prescription pattern among patients having mild to moderate bronchial asthma using metered dose inhaler and dry powder inhaler in tertiary hospital in western india

“…Among pMDI users, the commonest inhaled corticosteroid used was fluticasone and commonest combination used was inhaled fluticasone and salmeterol, these findings were similar to previous study. 9 Among DPI, commonest ICS used was budesonide rotacap and commonest combination was inhaled budesonide and formoterol, this was in concurrence with previous study. 10 The prescription pattern for selection of drug class and route of administration is in accordance with the Global initiative for asthma and Britain thoracic society guidelines.…”

Prescription Patterns of Asthma Preventers Among Children and Adolescents Between Australia and South Korea

“…Reasons for asthma preventer prescribing differences between Australia and South Korea are not clear from this study, however it is possible that differing cultures, medical systems, asthma prevalence, asthma guidelines and perceptions of safety play a role. Firstly, Korea’s preference towards LTRAs and xanthines is possibly due to Korean culture’s preference for oral medications and customary use of traditional herbal and complementary medicines ( Sol et al, 2019 ; Suh et al, 2017 ; Chiu et al, 2014 ). Chiu et al (2014) conducted questionnaires to assess parents’ perceptions towards asthma treatment in Asia, which found that parents and patients favoured oral tablets because they had perceptions that herbal medicines which are in tablet form, are safer than inhalers leading to lower adherence to inhalers ( Chiu et al, 2014 ; Abu-Shaheen et al, 2016 ; Lycett et al, 2018 ).…”