Ten-year prescription trends of asthma medications in the management of childhood wheeze

Abstract

Asthma is the most common chronic disorder of childhood. The aim of this study was to assess prescription trends of asthma medications to provide a measure to evaluate treatment practices and compliance with established international practice guidelines. A retrospective study of data obtained from outpatient prescription databases (2001-2010) of the University Children's Medical Institute for children aged 0-18 years was performed. The following drugs were included: short-acting beta-agonists (SABAs), long-acting beta-agonists in combination with inhaled corticosteroids (LABA-ICSs), ICS, and leukotriene receptor antagonists. Statistical analysis of prescription trends was performed with linear regression to determine the trends in prescription of controller medications. From 2001 to 2010, the number of patients who were prescribed SABA increased significantly by 72% (p = 0.016). The increases in ICS patient numbers and ICS/SABA drug unit ratios were significant only in the school-going (>5 years) age group. There was a trend away from the use of nebulized SABA and ICS, although this was statistically insignificant. LABA-ICS patient numbers decreased significantly by 32.4% (p = 0.003), especially in preschoolers (1-5 years). There was a corresponding rise in montelukast patient numbers by 194.6% (p = 0.009) and montelukast/SABA ratio by 345.3% (p = 0.032) in preschoolers (aged 1-5 years). Montelukast patient numbers, but not the montelukast/SABA ratio, increased in school-going children. The move away from LABA-ICS combination especially in younger children and a tendency toward more montelukast usage is a reflection of practice preferences in accordance with current international guidelines in young children.

A comparison of the costs of bronchodilator delivery methods in children with asthma exacerbations treated in hospital. The first Polish study in children

“…Short-acting β 2 -agonists and their combinations with short-acting muscarinic antagonists (SAMA) are, next to corticosteroids (ICS), the most commonly used inhaled drugs in children [1,2,[19][20][21]. They are used in the therapy of various diseases, although for many years they have been mainly used in the treatment of asthma [1][2][3].…”

Shellfish/crustacean oral allergy syndrome among national service pre-enlistees in Singapore

“…Allergic diseases are common in Singapore among children and adolescents (defined as up to 21 years old in the Singapore content), especially asthma [ 1 ], allergic rhinitis [ 2 ], and atopic dermatitis [ 3 ]. House dust mite is the most important inhalant allergen driving allergic sensitization in these 3 conditions in Singapore and Southeast Asia [ 4 5 ], more so than grass and tree pollen.…”

Perspectives on chronic urticaria/angioedema and its treatment

“…Continuing with the combination therapy for asthma theme, in an exclusive online publication also represented by an abstract printed in this issue, prescribing patterns for LABA-ICS combination therapy in Singapore are examined by Soh et al 14 as part of an assessment of asthma treatment practices and compliance with established international practice guidelines. They report that over a ten-year period, LABA-ICS patient prescriptions decreased significantly, especially in pre-schoolers (1-5 yrs) and that there was a corresponding rise in montelukast prescriptions.…”