Respiratory symptoms in young infancy: child, parent and physician related determinants of drug prescription in primary care.
OBJECTIVE
Respiratory symptoms account for the majority of drug prescriptions in the first year of life. We investigated the influence of child, parent and physician factors on drug prescriptions for respiratory symptoms in primary care in infancy.


METHODS
Infants participated in the WHeezing Illnesses STudy LEidsche Rijn (WHISTLER), a prospective birth cohort on respiratory illnesses. Outcome was defined as having received a prescription of antibiotics or of anti-asthma medication for respiratory symptoms by a physician.


RESULTS
Nearly 60% of all children ever visited a physician for respiratory symptoms during the first year of life, of which 40% received a prescription. Every extra day with symptoms during the month before consultation and each extra visit to a physician were associated with a higher chance for prescription (respectively odds ratios (OR) 1.07/2.63, 95% confidence intervals (CI) 1.02-1.12/1.83-3.76). Further, we found a higher chance for drug prescribing for boys (2.7, 2.0-3.7), children attending day care (1.17, 1.09-1.25), mothers with higher education (2.3, 1.2-4.6), working mothers (4.5, 0.9-22.0) and older mothers (years) (1.09, 1.02-1.16). Furthermore, physicians' years of experience was a determinant for receiving a prescription (2.5, 1.1-6.0). Accounting for symptoms and visits as strong predictors of prescribing, infant gender and day care attendance were still predictors. Furthermore, infant gender, day care attendance, family history of asthma and physicians' years of experience were independent determinants of the number of prescriptions besides symptoms and visits.


CONCLUSIONS
In young infancy, besides the severity of symptoms there are child, physician and particularly maternal characteristics that influence the decision of general practitioners to prescribe drugs for respiratory symptoms.
de Jong
Brita M
BM
Department of Pediatric Pulmonology, University Medical Center Utrecht, Utrecht, The Netherlands.
van der Ent
Cornelis K
CK
van der Zalm
Marieke M
MM
van Putte-Katier
Nienke
N
Verheij
Theo J M
TJ
Kimpen
Jan L L
JL
Uiterwaal
Cuno S P M
CS
D000367:Age Factors; D015331:Cohort Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008019:Life Style; D008297:Male; D009426:Netherlands / Q000453:epidemiology; D010287:Parent-Child Relations; D010819:Physician's Role; D055553:Prescription Drugs / Q000627:therapeutic use; D011320:Primary Health Care / Q000379:methods* / Q000706:statistics & numerical data; D011446:Prospective Studies; D012120:Respiration Disorders / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D012737:Sex Factors
D055553:Prescription Drugs