Medications prescribed to asthmatic children: an historical cohort study comparing clinical practice with NIH recommendations.
Purpose - NIH guidelines recommend maintenance treatment of persistent moderate or severe childhood asthma with preventive anti-inflammatory medication (inhaled corticosteroids, cromolyn or nedocromil). The objective was to determine if the NIH guidelines for the treatment of childhood asthma were implemented by examining the prevalence of prescribing preventive medication.Methods - This was a non-concurrent cohort study of 311 children (aged 2 to 19 years) who were treated for asthma between January and December 1994 by nine Medicaid managed care plans in the northeastern USA.Results - Preventive medications were prescribed at least once to 61.1% of the children with moderate or severe asthma and to 27.1% of the children with mild asthma. Logistic regression analyses indicated prescribing preventive medication was associated with moderate or severe asthma (aOR 5.34, 95% CI 3.22 - 8.83) and age 5 to 19 years (aOR 2.11, 95% CI 1.19 - 3.72). Prescribing preventive medication was also associated with a prior emergency department visit (aOR 2.27, 95% CI 1.24 - 4.16), after adjusting for age.Conclusions - Prescribing preventive medications is related to sentinel clinical events and the NIH recommendations are not routinely implemented for all children with moderate or severe asthma during this study period. Copyright (c) 2000 John Wiley & Sons, Ltd.
Ward Phd
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College of Pharmacy, University of Rhode Island, Kingston, Rhode Island, USA.
Willey Phd
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Andrade Scd
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