Use of asthma controller drugs at admission to a pediatric pulmonology outpatient clinic

Abstract

Objective: inhaled corticosteroids are widely used in developed countries. On the other hand, due to its high cost, this kind of drug is underused in asthmatic patients living in developing countries. The present study aims at verifying the use of controller medication in children with moderate or severe persistent asthma at admission to a specialized outpatient facility.Methods: descriptive study with 560 children aged 4 to 14, with diagnosed asthma, who were admitted between April 1996 and December 2000. The patients were randomly selected.Results: of 560 patients, 61.8% were male; 69.5% were between 4 and 9 years old. The first acute attack occurred before the first year of life in 55.8% of the cases, and 70.5% had physician-diagnosed persistent moderate asthma. In the previous 12 months, 42.7% of the children had been admitted to hospital and 92.7% were assisted in emergency rooms. Considering those living in the metropolitan area of Belo Horizonte, the average use of some kind of controller drug was 27.3%, and 17.1% of inhaled corticosteroids. The use of oral corticosteroids decreased from 14.3% in 1996 to 4.2% in 2000.Conclusions: the rate of inhaled corticosteroid therapy was higher than those found in Brazilian studies and it is comparable to the results of some international studies. A decrease in the use of oral corticosteroids was also observed. Both findings may be related to the implementation of an asthma program in the public health system of Belo Horizonte, which began in 1996. J Pediatr (Rio J) 2003;79(3):233-8: asthma, antiasthmatic agents, prevention and control.

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

“…Inhaled corticosteroids, the main pharmacological choice for control of this disease, were reported to have been used by only one child in this population. Other studies conducted in Brazil, although focused on children cared for in health units, found frequencies of use of inhaled corticosteroids between 2 and 6% [ 18 , 29 ].…”

“…Rosário Filho reported an increase in spending on drugs for asthma treatment and in hospitalizations due to this disease [ 16 ]. Other studies performed in children with asthma in the public health care facilities in Brazil revealed small proportions of use of anti-inflammatory treatment, ranging from 6.0 to 14.0% [ 17 , 18 ]. In Brazil, the lack of population-based studies on the use of anti-asthmatics in children, as well as on the reasons for this lack, necessitates such studies, particularly as the use of these drugs is considered an indirect indicator of quality of care provided to asthmatic children.…”