Pattern of asthma medication use among children from a large urban center in Brazil

Abstract

PurposeDespite the advances in asthma therapeutics, there are few data on the use and determinants of anti-asthmatic drugs in the general population of children. This study describes the use of asthma medications among children in the general population and in children with current asthma, living in a large urban center in Brazil.MethodsA population-based cross-sectional survey, aimed at analyzing asthma determinants, was conducted with 1,382 children aged 4–11 years, between February and May 2006, in Salvador, Brazil. At baseline, an extensive questionnaire was applied, including questions about the use of asthma medications in the last 12 months.ResultsIn all studied children (n = 1,382) aged 4–11 years, oral beta2-agonists were the drugs most frequently used (9.8%), followed by short-acting inhaled beta2-agonists (4.3%) and systemic corticosteroids (1.6%). Anti-asthmatic drug use was higher among males than females, and it significantly decreased with age in both genders. A total of 312 children (22.6%) reported current asthma, and 62% of them were not being treated with any anti-asthmatic drugs. Of all those who reported following a certain type of treatment, 20% used oral beta2-agonists alone; 6.1%, short-acting inhaled beta2-agonists alone; and 4.8%, a combination of both drugs. Anti-asthmatic drug use did not differ according to socioeconomic status, except for the use of inhaled beta2-agonists and systemic corticosteroids.ConclusionsAn overwhelming majority of asthmatic children were not using long-term medications for asthma, in particular inhaled corticosteroids, regardless of the severity of their disease. This result points to the deficiencies of the Brazilian public health system in recognizing this important pharmacological need for child care and thereby limiting the access of these children to a group of efficacious, available, and low risk therapeutic medications.

The effect of internalization and other psychologic factors on the remission and severity of wheeze in children

“…Another potential limitation is the absence of information regarding the effect of treatment on the remission of asthma symptoms. However, in this population, medication for asthma is reported to be highly underused and only one child reported the use of inhaled corticosteroids. Therefore, it was not possible to analyze the data regarding medication.…”

Proposta De Otimização Do Uso De Bromidrato De Fenoterol Gotas Para Prática Inalatória

“…Em trabalho com antitérmicos no setor de pediatria do Hospital Santo Antônio de Porto Alegre -RS verificou-se que gotejadores de diversas apresentações disponibilizam volumes/quantidades diversos o que ocasionam erros nas medicações pediátricas disponibilizadas em conta-gotas (SUKIENNIK et al, 2006). Alta variabilidade nas dosagens de medicamentos de uso pediátrico pode implicar em aparecimento de reações adversas, levando a quadros de hospitalizações (SANTOS et al;2012). De acordo com ANVISA e INMETRO, não existem normas técnicas ou regulamentação sobre a utilização de conta-gotas.…”

“…No entanto, sua comercialização está proibida nos Estados Unidos e há relatos de casos de mortes devido ao seu uso na Nova Zelândia (HOFFMAN, 2003). No Brasil, 22% das crianças com quadro asmático são tratadas com fenoterol e a utilização é crescente nessa faixa etária (SANTOS et al, 2012).…”

A Community Study of Factors Related to Poorly Controlled Asthma among Brazilian Urban Children

“…None of wheezing children was receiving controller medications, most had rescue oral bronchodilators for use during exacerbations as their only treatment [25]. Regarding the socioeconomic status, 43.4% of mothers had not completed high school (160/369), the predominant type of constructions was brick houses (354/370, 95.7%) with piped water and sewage system present in 82.7% and 83.6% of them, respectively.…”

“…From the survey of 1445 children, the guardians of 417 (28.9%) reported that the children had wheezing in the last 12 months; of these, 374 (89.7% of 417) had complete data set and were included in the present analysis. None of wheezing children was receiving controller medications, most had rescue oral bronchodilators for use during exacerbations as their only treatment [25] . Regarding the socioeconomic status, 43.4% of mothers had not completed high school (160/369), the predominant type of constructions was brick houses (354/370, 95.7%) with piped water and sewage system present in 82.7% and 83.6% of them, respectively.…”