Assessment of pediatric asthma drug use in three European countries; a TEDDY study.
Asthma drugs are amongst the most frequently used drugs in childhood, but international comparisons on type and indication of use are lacking. The aim of this study was to describe asthma drug use in children with and without asthma in the Netherlands (NL), Italy (IT), and the United Kingdom (UK). We conducted a retrospective analysis of outpatient medical records of children 0-18 years from 1 January 2000 until 31 December 2005. For all children, prescription rates of asthma drugs were studied by country, age, asthma diagnosis, and off-label status. One-year prevalence rates were calculated per 100 children per patient-year (PY). The cohort consisted of 671,831 children of whom 49,442 had been diagnosed with asthma at any time during follow-up. ß2-mimetics and inhaled steroids were the most frequently prescribed asthma drug classes in NL (4.9 and 4.1/100 PY), the UK (8.7 and 5.3/100 PY) and IT (7.2 and 16.2/100 PY), respectively. Xanthines, anticholinergics, leukotriene receptor antagonists, and anti-allergics were prescribed in less than one child per 100 per year. In patients without asthma, ß2-mimetics were used most frequently. Country differences were highest for steroids, (Italy highest), and for ß2-mimetics (the UK highest). Off-label use was low, and most pronounced for ß2-mimetics in children <18 months (IT) and combined ß2-mimetics + anticholinergics in children <6 years (NL).


CONCLUSIONS
This study shows that among all asthma drugs, ß2-mimetics and inhaled steroids are most often used, also in children without asthma, and with large variability between countries. Linking multi-country databases allows us to study country specific pediatric drug use in a systematic manner without being hampered by methodological differences. This study underlines the potency of healthcare databases in rapidly providing data on pediatric drug use and possibly safety.
Sen
Elif Fatma
EF
Department of Medical Informatics, Erasmus University Medical Center, Suite Ee 21.55, Dr Molewaterplein 50, PO Box 2040, 3000 CA Rotterdam, The Netherlands. e.f.sen@erasmusmc.nl
Verhamme
Katia M C
KM
Neubert
Antje
A
Hsia
Yingfen
Y
Murray
Macey
M
Felisi
Mariagrazia
M
Giaquinto
Carlo
C
't Jong
Geert W
GW
Picelli
Gino
G
Baraldi
Eugenio
E
Nicolosi
Alfredo
A
Ceci
Adriana
A
Wong
Ian C
IC
Sturkenboom
Miriam C J M
MC
D000293:Adolescent; D000318:Adrenergic beta-Agonists / Q000627:therapeutic use*; D018926:Anti-Allergic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D018680:Cholinergic Antagonists / Q000627:therapeutic use*; D015331:Cohort Studies; D003345:Corticosterone / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D009426:Netherlands; D056687:Off-Label Use; D012189:Retrospective Studies; D006113:United Kingdom
D000318:Adrenergic beta-Agonists; D018926:Anti-Allergic Agents; D018680:Cholinergic Antagonists; D003345:Corticosterone
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