title: Ten-year prescription trends of asthma medications in the management of childhood wheeze.
abstract: Asthma is the most common chronic disorder of childhood. The aim of this study was to assess prescription trends of asthma medications to provide a measure to evaluate treatment practices and compliance with established international practice guidelines. A retrospective study of data obtained from outpatient prescription databases (2001-2010) of the University Children's Medical Institute for children aged 0-18 years was performed. The following drugs were included: short-acting beta-agonists (SABAs), long-acting beta-agonists in combination with inhaled corticosteroids (LABA-ICSs), ICS, and leukotriene receptor antagonists. Statistical analysis of prescription trends was performed with linear regression to determine the trends in prescription of controller medications. From 2001 to 2010, the number of patients who were prescribed SABA increased significantly by 72% (p = 0.016). The increases in ICS patient numbers and ICS/SABA drug unit ratios were significant only in the school-going (>5 years) age group. There was a trend away from the use of nebulized SABA and ICS, although this was statistically insignificant. LABA-ICS patient numbers decreased significantly by 32.4% (p = 0.003), especially in preschoolers (1-5 years). There was a corresponding rise in montelukast patient numbers by 194.6% (p = 0.009) and montelukast/SABA ratio by 345.3% (p = 0.032) in preschoolers (aged 1-5 years). Montelukast patient numbers, but not the montelukast/SABA ratio, increased in school-going children. The move away from LABA-ICS combination especially in younger children and a tendency toward more montelukast usage is a reflection of practice preferences in accordance with current international guidelines in young children.
authors.affiliation: Department of Pediatrics, University Children's Medical Institute, National University Health System, Singapore.
authors.forename: Jian Yi
authors.initials: JY
authors.lastname: Soh
authors.forename: Beatrice
authors.initials: B
authors.lastname: Ng
authors.forename: Zeying
authors.initials: Z
authors.lastname: Tan
authors.forename: Shuhui
authors.initials: S
authors.lastname: Xu
authors.forename: Wee Chuan
authors.initials: WC
authors.lastname: Hing
authors.forename: Tuck Seng
authors.initials: TS
authors.lastname: Wu
authors.forename: Yiong Huak
authors.initials: YH
authors.lastname: Chan
authors.forename: Bee Wah
authors.initials: BW
authors.lastname: Lee
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000318:Adrenergic beta-Agonists / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage; D001249:Asthma / Q000188:drug therapy / Q000453:epidemiology*; D002648:Child; D002675:Child, Preschool; D004333:Drug Administration Routes; D011307:Drug Prescriptions / Q000592:standards / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020024:Leukotriene Antagonists / Q000008:administration & dosage; D008297:Male; D017410:Practice Guidelines as Topic; D012135:Respiratory Sounds / Q000187:drug effects; D012189:Retrospective Studies; D062606:Tertiary Care Centers
chemical_list: D000305:Adrenal Cortex Hormones; D000318:Adrenergic beta-Agonists; D018927:Anti-Asthmatic Agents; D020024:Leukotriene Antagonists