Influence of ethnic group on asthma treatment in children in 1990-1: national cross sectional study.
OBJECTIVE
To examine the extent to which the prescription of drugs for asthma adhered to recommended guidelines in 1990-1 and to assess the influence of ethnic group on prescription.


METHODS
Cross sectional.


METHODS
Primary schools in England and Scotland in 1990-1.


METHODS
Children aged mainly 5-11 years. The representative samples included 10628 children. The inner city sample included 7049 children, 4866 (69%) from ethnic minority groups. For the prevalence estimation 14490 children were included in the analysis (82% of the eligible children). For the treatment analysis a subgroup of 5494 children with respiratory symptoms was selected.


METHODS
Prevalence of respiratory symptoms and drugs commonly prescribed for asthma, method of administration, inappropriate treatment, and odds ratios to assess the effect of ethnic group on rate of prescription and method of administration.


RESULTS
Children with respiratory symptoms in the inner city sample were less likely to be diagnosed as having asthma. Of children with reported asthma attacks, those in inner city areas had a higher risk of not having been prescribed any drug for asthma (odds ratio 1.87 (95% confidence interval 1.26 to 2.77). Overall, 773 (75%) of these children had received a beta 2 agonist, 259 (25%) had received steroids, 148 (14%) had received sodium cromoglycate, and 194 (19%) had received no drug treatment in the previous year. When prescribed, beta 2 agonists were inhaled in 534 (69%) of cases, and this percentage was even lower in ethnic minority groups. Children of Afro-Caribbean and Indian subcontinent origin who had asthma were less likely to receive beta 2 agonists, and those from the Indian subcontinent were less likely to receive anti-inflammatory drugs. Antibiotics were less prescribed and antitussives more prescribed in children from ethnic minority groups than in white children.


CONCLUSIONS
In 1990-1 the risk of underdiagnosis and undertreatment of asthma was higher in children from ethnic minority groups. The implementation of indicators and targets to monitor inequalities in the treatment of asthma in ethnic groups could improve equity and effectiveness in the NHS.
Duran-Tauleria
E
E
Department of Public Health Medicine, United Medical School of Guy's Hospital, London.
Rona
R J
RJ
Chinn
S
S
Burney
P
P
D000318:Adrenergic beta-Agonists / Q000627:therapeutic use; D001208:Asia / Q000208:ethnology; D001249:Asthma / Q000175:diagnosis / Q000188:drug therapy* / Q000208:ethnology*; D001993:Bronchodilator Agents / Q000627:therapeutic use; D017691:Caribbean Region / Q000208:ethnology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data*; D004739:England; D005006:Ethnicity / Q000706:statistics & numerical data*; D006801:Humans; D016017:Odds Ratio; D015995:Prevalence; D012606:Scotland; D014505:Urban Population
D000318:Adrenergic beta-Agonists; D001993:Bronchodilator Agents