Trends in medication use for asthma in school-entry children in the Australian Capital Territory, 2000-2005.
OBJECTIVE
To analyse trends in asthma medications used by school-entry children whose parents report they have asthma.


METHODS
Annual cross-sectional study of all school-entry children (about 4400 each year) in the Australian Capital Territory in 2000-2005, by means of a questionnaire for parents on child health status and medication use; and a cross-sectional study of asthma prescriptions for children aged 5 years obtained from the Medicare Australia database for 2002-2005.


METHODS
All school-entry children in the ACT with parent-reported asthma (numbers in the years 2000-2005 ranged between 435 and 589).


METHODS
Changes in the use of different medications; changes in delivery devices for asthma; changes in the potency of inhaled fluticasone.


RESULTS
Response rates to kindergarten health screening were in the range 85%-89% for 2000-2005. Parent-reported asthma prevalence ranged from 11% to 15%. Each year, around 35% of children with asthma (age range, 4-6 years) used inhaled corticosteroids. An increase in the use of fluticasone (from 11% to 33% of children with asthma) was offset by decreases in beclomethasone use (from 14% to 3%) and budesonide (from 14% to 4%). Use of cromoglycate and nedocromil fell from 46% to 16%. Nebuliser use decreased (from 45% to 20%), while the use of spacer devices increased (from 70% to 83%). Use of combined salmeterol/fluticasone increased from 8% (in 2002) to 20% (in 2005) of children with parent-reported asthma. These trends were mirrored in Medicare Australia data for 5-year-old children in the ACT.


CONCLUSIONS
There was marked volatility in the types of asthma medication used over the 6 years. Reciprocal trends leading to increased use of spacers and decreased use of nebulisers are in accord with national guidelines for better asthma management. The increasing use of products containing a combination of salmeterol and fluticasone requires ongoing monitoring.
Phillips
Christine B
CB
Academic Unit of General Practice and Community Health, Australian National University, Canberra, ACT, Australia. christine.phillips@anu.edu.au
Toyne
Helen
H
Ciszek
Karen
K
Attewell
Robyn G
RG
Kljakovic
Marjan
M
D000280:Administration, Inhalation; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology*; D020958:Australian Capital Territory / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000639:trends*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D009330:Nebulizers and Vaporizers / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires
D018927:Anti-Asthmatic Agents; D005938:Glucocorticoids