Prescribing of asthma medication in primary care for children aged under 10

Schokker, Siebrig; Groenhof, Feikje; Veen, Willem Jan van der; Molen, Thys van der

doi:10.4104/pcrj.2009.00039

Cited by 15 publications

(25 citation statements)

References 24 publications

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“…This excellent paper by Schokker et al 3 provides healthcare practitioners with a range of insights into the behaviour of clinicians, patients, and indeed respiratory illnesses in a well studied group of children in Northern Europe. Although limited by the available data, the research suggests a link between the early need for poly-pharmaceutical interventions and ongoing significant levels of inhaled treatment -a link that may add to our ability to predict with some confidence those children who go on to have persisting asthma in later life, thus helping us to identify them within the larger group of symptomatic infants treated in primary care.…”

Section: Resultsmentioning

confidence: 99%

“…3 This may seem low when compared with some of the contemporary and long running prevalence studies in a number of European populations [6][7][8] where asthma prevalence in children has been reported as being as high as 35%. However, in this study, a different indicator was used -the 1000 person year -as opposed to data being gained from population symptom surveys that are likely to give a higher yield of symptomatic children.…”

Section: How Often Were Asthma Medications Prescribed and For What Rmentioning

confidence: 87%

“…Although the prescribing database used in this study was robust and comprehensive, 3 the population included is relatively small (30,000 people), with a total childhood population of 3,600 in a limited number of clinical settings (three practices). Therefore, there is a concern regarding the external validity of the clinical patterns observed.…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, there is often inconsistent (or indeed insufficient) evidence to support the use of commonly prescribed treatments, leaving primary care clinicians to make decisions based on a combination of experience, peer opinion, and anecdote. 2 However, in this issue of the PCRJ, Schokker et al 3 have analysed the way in which primary care doctors in Holland prescribe asthma medicines such as short-acting β 2-agonists (SABA), long-acting β2-agonists, (LABA), and inhaled corticosteroids (ICS), and in so doing have shed some light on this complex issue.…”

Section: Commentarymentioning

confidence: 99%

“…after their 6th prescription, compared to 40% at first prescription. 3 There were therefore a significant number of patients receiving frequent prescriptions without a diagnostic label of asthma. Two conclusions may be drawn from this pattern of behaviour: firstly, either clinicians are reluctant to make the diagnosis (even in the presence of persisting presentations for treatment); or secondly, they are using asthma medicines to treat a range of other conditions.…”

Section: How Often Were Asthma Medications Prescribed and For What Rmentioning

confidence: 99%

See 4 more Smart Citations

Re: Schokker et al. Prim Care Resp J 2010;19(1):28–34 Prescribing of asthma medication in primary care for children aged under 10

Small

2010

Primary Care Respiratory Journal

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Section: Resultsmentioning

confidence: 99%

Section: How Often Were Asthma Medications Prescribed and For What Rmentioning

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Commentarymentioning

confidence: 99%

Section: How Often Were Asthma Medications Prescribed and For What Rmentioning

confidence: 99%

See 3 more Smart Citations

Re: Schokker et al. Prim Care Resp J 2010;19(1):28–34 Prescribing of asthma medication in primary care for children aged under 10

Small

2010

Primary Care Respiratory Journal

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Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Mikalsen

Dalen

Karlstad

et al. 2019

Pediatric Pulmonology

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Diagnosing asthma and deciding treatment are difficult in young children. An inappropriate and too high prescription rate of inhaled corticosteroids (ICS) is suggested, but how airway symptoms are associated with prescriptions of asthma medication is less known. We studied how strongly wheeze, lower respiratory tract infections (LRTI), and atopic diseases are associated with dispensing of asthma medications during early childhood. We used data from the Norwegian Mother and Child Cohort Study and the Norwegian Prescription Database at four age‐intervals (0‐6, 6‐18, 18‐36 months, and 3‐7 years). Primary outcomes were dispensed asthma medications (no medication, short‐acting β‐2 agonist, or ICS). Relative risks (RRs) and average attributable fractions (AAFs) were estimated. Both wheeze and LRTI were positively associated with both medication groups (0‐6 months: no data on wheeze). The RRs and AAFs were higher for wheeze than LRTI. For ICS, the AAFs (95% CI) for wheeze vs LRTI were: 6 to 18 months: 69.2 (67.2, 71.2)% vs 10.4 (9.0, 11.8)%, 18 to 36 months: 33.0 (30.5, 35.5)% vs 10.0 (8.0, 12.0)%, and 3 to 7 years: 33.7 (31.0, 36.5)% vs 1.2 (0.5, 1.9)%. Except at 3 to 7 years of age, the AAFs were lower for atopic diseases than for LRTI and wheeze. Atopic diseases modified the associations between wheeze and ICS at 18 to 36 months and between LRTI or wheeze and ICS at 3 to 7 years. In conclusion, both wheeze and LRTI were associated with prescriptions of asthma medications in young children, with the strongest associations seen for wheeze. Atopic diseases contributed to these associations only in the oldest age groups.

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Identification of Dutch children diagnosed with atopic diseases using prescription data: a validation study

Mulder

Groenhof

Kocabas

et al. 2015

Eur J Clin Pharmacol

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PurposeThe aim of this study is to validate medication proxies for the identification of children diagnosed with atopic disorders that can be applied in various types of epidemiological research.MethodsRecords of 7439 children, aged between 0 and 10 years, in the period 2001 until 2010, were retrieved from the Registration Network Groningen database, a general practitioners database in the north-eastern part of the Netherlands. The sensitivity and positive predictive value (PPV) of 22 medication proxies for the identification of children diagnosed with atopic disorders (asthma, atopic dermatitis, and allergic rhinitis) were computed using the registered diagnoses as gold standards. In addition, different capture periods (1 year, half year, and length of study period) for the detection of prescriptions were tested for all the medication proxies.ResultsThe highest PPV (0.84, 95 % CI 0.81–0.87) in combination with a sufficient sensitivity value (0.54, 95 % CI 0.50–0.57) for the identification of children diagnosed with asthma was yielded for the medication proxy, ≥2 prescriptions for anti-asthma medication within 1 year, including 1 inhaled steroid. PPV and sensitivity were even higher in the age group 6–10 years. The proxies designed for the identification of children diagnosed with atopic dermatitis and allergic rhinitis yielded only high PPVs (≥0.75) in combination with low sensitivity values (≤0.22). Altering the capture period for the detection of prescriptions to half a year or the length of the study period only affected sensitivity values.ConclusionChildren diagnosed with asthma can be identified reliably with a range of medication proxies. The use of prescription data for the identification of children diagnosed with atopic dermatitis and allergic rhinitis is questionable.

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Prescribing of asthma medication in primary care for children aged under 10

Cited by 15 publications

References 24 publications

Re: Schokker et al. Prim Care Resp J 2010;19(1):28–34 Prescribing of asthma medication in primary care for children aged under 10

Re: Schokker et al. Prim Care Resp J 2010;19(1):28–34 Prescribing of asthma medication in primary care for children aged under 10

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Identification of Dutch children diagnosed with atopic diseases using prescription data: a validation study

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