title: Allergic rhinitis in children: incidence and treatment in Dutch general practice in 1987 and 2001.
abstract: Allergic rhinitis is a common chronic disorder in children, mostly diagnosed in primary health care. This study investigated the national incidence and treatment of allergic rhinitis among children aged 0-17 yr in Dutch general practice in 1987 and 2001 to establish whether changes have occurred. A comparison was made with data from the first (1987) and second (2001) Dutch national surveys of general practice on children aged 0-17 yr. Incidence rates were compared by age, sex, level of urbanization and season. The management of the general practitioner was assessed regarding drug prescriptions and referrals to medical specialists, and compared with the clinical guideline issued in 1996. The incidence rate of allergic rhinitis increased from 6.6 (1987) to 9.2 (2001) per 1000 person-years. We found a male predominance with a switch in adolescence to a female predominance at both time points. The increase in incidence was the highest in rural (<30,000 inhabitants) and suburban areas (30,000-50,000 inhabitants). Compared to 1987, there was a significant increase in incidence in the central part of the Netherlands in 2001. In both years, the incidence was higher in spring compared with the other seasons. In 2001, children of natives and western immigrants visited the general practitioner more often with complaints of allergic rhinitis compared to 1987. In 1987, prescribed medication consisted mainly of nasal corticosteroids (36%) and in 2001 of oral antihistamines (45%). Although a clinical guideline was not issued until 1996, overall, the treatment of allergic rhinitis by general practitioners was in both years in accordance with the current clinical guideline, but with a stronger adherence in 2001. The results show an increased incidence in the past decades of allergic rhinitis in children in Dutch general practice. The shift to a smaller spectrum of prescriptions in 2001 may be a result of the 1996 clinical guideline.
authors.affiliation: Department of General Practice, Erasmus MC - University Medical Center Rotterdam, 3000 CA Rotterdam, The Netherlands. c.debot@erasmusmc.nl
authors.forename: Cindy M A
authors.initials: CM
authors.lastname: de Bot
authors.forename: Heleen
authors.initials: H
authors.lastname: Moed
authors.forename: François G
authors.initials: FG
authors.lastname: Schellevis
authors.forename: Hans
authors.initials: H
authors.lastname: de Groot
authors.forename: Roy Gerth
authors.initials: RG
authors.lastname: van Wijk
authors.forename: Johannes C
authors.initials: JC
authors.lastname: van der Wouden
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000592:standards*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010821:Physicians, Family; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012017:Referral and Consultation; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000453:epidemiology* / Q000209:etiology
chemical_list: D000305:Adrenal Cortex Hormones; D018926:Anti-Allergic Agents