Background: Inhaled corticosteroids (ICS) are effective treatment for childhood asthma. Cross sectional studies indicate that some asthmatic children are treated with excessively high dose ICS and are at risk for serious adverse effects.
Objective: The aim of the present study was to describe longitudinal trends in asthma prescribing for children, with particular reference to high dose ICS prescribing.
Design: This was a retrospective, cross sectional, observational study of general practitioner prescribing for asthma medications in children aged under 12 years with a recorded asthma diagnosis between 1992 and 2004 using the General Practice Research Database (GPRD).
Results: Data were available for an average of 357, 956 children per year. The percentage of children prescribed ICS increased from 2.7% in 1992 to 7.0% in 1997 and 1998 and then fell to 3.3% in 2004. In the under five-year-olds with asthma, high dose ICS prescriptions (>400 mcg/day) fell from 10.6% of all ICS prescriptions in 1992 to 4.5% by 2004. In contrast, high dose ICS prescriptions (>800 mcg/day) for asthmatic 5-11 year-olds rose from 1.1% in 1992 to 4.6% in 2004. Oral corticosteroid prescribing in under 5 year olds asthmatics prescribed ICS fell from 37.1% in 1992 to 21.7% 1999 and remained constant thereafter; the respective percentages for 5-11 year olds were 20.1% and 12.4%.
Conclusions: Trends for prescribing in childhood asthma changed dramatically and there are several plausible reasons for this.