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Paediatric prescribing of asthma drugs in the UK: are we sticking to the guideline?
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  1. Simon Cohen1,
  2. Jonny Taitz1,
  3. Adam Jaffé1,2
  1. 1
    Sydney Children’s Hospital and University of New South Wales, High Street, Randwick, NSW 2031, Australia
  2. 2
    Portex Respiratory Unit, Institute of Child Health, 30 Guilford St, London WC1N 1EH, UK
  1. Simon Cohen, Sydney Children’s Hospital and University of New South Wales, High Street, Randwick, NSW 2031, Australia; simoncohen11{at}yahoo.co.uk

Abstract

Background: Asthma guidelines should lead to improved, more rational asthma medication prescribing. The aims of this study were to assess trends in paediatric asthma drug prescribing in the UK and to assess the potential impact of the publication of the British Thoracic Society (BTS) asthma guideline.

Methods: The estimated community paediatric prescribing figures for asthma medications in the UK were studied using data from the NHS Information Centre for Health and Social Care for the years 2000–2006.

Results: The numbers of prescriptions for bronchodilator syrups decreased by 60% from 2000 to 2006. However, this still represents 121 000 prescriptions for bronchodilator syrups in 2006 despite minimal recommendations for their use. The percentage of steroid inhalers prescribed as combination inhalers of a steroid and a long-acting β agonist increased from 2.6% in 2000 to 20.6% in 2006.

Conclusions: Steroid-alone inhalers should be the mainstay for the vast majority of patients with asthma who require controller medications. The increase in the number of combination inhalers prescribed is not consistent with the guideline recommendations that combination inhalers should only be introduced in those patients with asthma not controlled on adequate doses of inhaled steroids. Further education of health professionals is required.

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Footnotes

  • Funding: This study did not receive specific funding.

  • Competing interests: SC and JT have no competing interests to declare. AJ is on the medical advisory panel of MSD. AJ has received funding from GSK and AstaZenca in the past.

  • SC was involved in the conception of the paper and the interpretation of data. SC, AJ and JT were involved in drafting the article and revising it critically for important intellectual comment. Only the authors and acknowledged parties were involved in study inception, analysis and interpretation.

  • Ethics approval was not required.

  • Note on data: These data remain the sole and exclusive property of The Information Centre and may only be reproduced where there is explicit reference to the ownership of The Information Centre.

  • Abbreviations:
    BTS
    British Thoracic Society
    GP
    general medical practitioner
    LABA
    long-acting β agonist
    LTRA
    leukotriene antagonist
    PCA
    Prescription Cost Analysis
    PPA
    Prescription Pricing Authority
    SIGN
    Scottish Intercollegiate Guidelines Network

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