title: Seasonal changes in prescribing of long-acting beta-2-agonists-containing drugs.
abstract: BACKGROUND
  For patients with asthma, COPD, or asthma-COPD overlap syndrome (ACOS), inter-country comparisons of seasonal changes in drug prescriptions are scarce or missing. Hence, we aimed to compare seasonal changes in prescription rates of long-acting beta-2-agonist (LABA) in four European countries.
  
  
  METHODS
  A common study protocol was applied to six health care databases (Germany, Spain, the Netherlands (2), and the UK (2)) to calculate age- and sex-standardized point prevalence rates (PPRs) of LABA-containing prescriptions by the 1st of March, June, September, and December of each year during the study period 2002-2009. Seasonal variation of PPRs was quantified using seasonal indexes (SIs; based on the ratio-to-moving-average-method) and SIs averaged over the study period (aSI) stratified by sex, age, and indication (asthma, COPD, or ACOS).
  
  
  RESULTS
  There was a moderate seasonal change in LABA-containing prescriptions which was more pronounced in asthma or COPD patients compared to ACOS patients. For asthma and ACOS patients, highest seasonal variation was found for patients living in Spain (aSI: 87.3-110.7, aSI: 93.2-103.1) whereas for COPD highest seasonal variation was revealed for the NPCRD database (the Netherlands) (aSI: 92.2-105.6). Regarding age and sex, highest seasonal variation was found in Spanish boys under 10 years of age having a diagnosis of asthma.
  
  
  CONCLUSIONS
  By applying a common analysis in six databases, we could observe moderate overall seasonal changes in LABA-containing prescription rates in patients with asthma, COPD, or ACOS.
authors.affiliation: Institute for Medical Information Sciences, Biometry, and Epidemiology, Ludwig-Maximilians-Universitaet Muenchen, Marchioninistr. 15, D-81377 Munich, Germany. Electronic address: rottenk@ibe.med.uni-muenchen.de.
authors.forename: M
authors.initials: M
authors.lastname: Rottenkolber
authors.affiliation: Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Universiteitsweg 99, NL-3584 CA Utrecht, The Netherlands; Netherlands Institute for Health Services Research, PO Box 1568, 3500 Utrecht, The Netherlands. Electronic address: eef.voogd@tno.nl.
authors.forename: E
authors.initials: E
authors.lastname: Voogd
authors.affiliation: Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Universiteitsweg 99, NL-3584 CA Utrecht, The Netherlands; Netherlands Institute for Health Services Research, PO Box 1568, 3500 Utrecht, The Netherlands. Electronic address: l.vandijk@nivel.nl.
authors.forename: L
authors.initials: L
authors.lastname: van Dijk
authors.affiliation: Novartis Pharma AG, Postfach, CH-4002 Basel, Switzerland. Electronic address: paola.primatesta@novartis.com.
authors.forename: P
authors.initials: P
authors.lastname: Primatesta
authors.affiliation: Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy & Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Hebelstrasse 2 (Markgräflerhof), CH-4031 Basel, Switzerland. Electronic address: claudia.becker@usb.ch.
authors.forename: C
authors.initials: C
authors.lastname: Becker
authors.affiliation: Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Universiteitsweg 99, NL-3584 CA Utrecht, The Netherlands. Electronic address: M.C.H.deGroot@uu.nl.
authors.forename: M C H
authors.initials: MC
authors.lastname: de Groot
authors.affiliation: Novartis Farmaceutica S.A., Gran Via de les Corts Catalanes 764, E-08013 Barcelona, Spain. Electronic address: estel.plana@gmail.com.
authors.forename: E
authors.initials: E
authors.lastname: Plana
authors.affiliation: European Medicines Agency, 30 Churchill Place, Canary Wharf, E14 5EU London, United Kingdom. Electronic address: yolanda.alvarez@ema.europa.eu.
authors.forename: Y
authors.initials: Y
authors.lastname: Alvarez
authors.affiliation: European Medicines Agency, 30 Churchill Place, Canary Wharf, E14 5EU London, United Kingdom. Electronic address: julie.durand@ema.europa.eu.
authors.forename: J
authors.initials: J
authors.lastname: Durand
authors.affiliation: European Medicines Agency, 30 Churchill Place, Canary Wharf, E14 5EU London, United Kingdom. Electronic address: jim.slattery@ema.europa.eu.
authors.forename: J
authors.initials: J
authors.lastname: Slattery
authors.affiliation: Faculty of Science, Utrecht Institute for Pharmaceutical Sciences, Division Pharmacoepidemiology and Clinical Pharmacology, Utrecht University, Universiteitsweg 99, NL-3584 CA Utrecht, The Netherlands. Electronic address: A.Afonso@uu.nl.
authors.forename: A
authors.initials: A
authors.lastname: Afonso
authors.affiliation: Pharmacology Unit, Department of Biomedical Sciences II, School of Medicine and Health Sciences, University of Alcalá, Calle 20, E-28805 Alcalá de Henares, Madrid, Spain. Electronic address: Gema.Requena@lshtm.ac.uk.
authors.forename: G
authors.initials: G
authors.lastname: Requena
authors.affiliation: BIFAP Unit, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Calle Campezo 1, Edificio 8, E-28022 Madrid, Spain. Electronic address: mgil_fcsai@bifap.org.
authors.forename: C
authors.initials: C
authors.lastname: Huerta
authors.affiliation: BIFAP Unit, Division of Pharmacoepidemiology and Pharmacovigilance, Spanish Agency for Medicines and Medical Devices, Calle Campezo 1, Edificio 8, E-28022 Madrid, Spain. Electronic address: aalvarez_fcsai@bifap.org.
authors.forename: A
authors.initials: A
authors.lastname: Alvarez
authors.affiliation: Pharmacology Unit, Department of Biomedical Sciences II, School of Medicine and Health Sciences, University of Alcalá, Calle 20, E-28805 Alcalá de Henares, Madrid, Spain; Clinical Pharmacology Unit, University Hospital Príncipe de Asturias, Carretera Alcalá-Meco s/n, E-28805 Alcalá de Henares, Spain. Electronic address: francisco.abajo@uah.es.
authors.forename: F
authors.initials: F
authors.lastname: de Abajo
authors.affiliation: National Association of Statutory Health Insurance Physicians of Bavaria, Elsenheimerstr. 39, D-80687 Munich, Germany. Electronic address: Martin.Tauscher@kvb.de.
authors.forename: M
authors.initials: M
authors.lastname: Tauscher
authors.affiliation: Institute for Medical Information Sciences, Biometry, and Epidemiology, Ludwig-Maximilians-Universitaet Muenchen, Marchioninistr. 15, D-81377 Munich, Germany. Electronic address: has@ibe.med.uni-muenchen.de.
authors.forename: J
authors.initials: J
authors.lastname: Hasford
authors.affiliation: Pneumologische Praxis München - Pasing, Gleichmannstr. 5, D-81241 Munich, Germany. Electronic address: rainald.fischer@gmail.com.
authors.forename: R
authors.initials: R
authors.lastname: Fischer
authors.affiliation: Epidemiology, Pfizer Inc., 235 E 42nd St, New York, NY 10017, USA. Electronic address: robert.reynolds@pfizer.com.
authors.forename: R
authors.initials: R
authors.lastname: Reynolds
authors.affiliation: Department of Clinical Pharmacology, School of Medicine, Faculty of Health, Witten/Herdecke University, Alfred-Herrhausen-Straße 50, D-58448 Witten, Germany; Philipp Klee-Institute for Clinical Pharmacology, Helios Clinic Wuppertal, Heusnerstr. 40, D-42283 Wuppertal, Germany. Electronic address: sven.schmiedl@helios-kliniken.de.
authors.forename: S
authors.initials: S
authors.lastname: Schmiedl
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D058666:Adrenergic beta-2 Receptor Agonists / Q000008:administration & dosage*; D000328:Adult; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D003692:Delayed-Action Preparations / Q000008:administration & dosage; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D010818:Practice Patterns, Physicians'; D012189:Retrospective Studies; D012621:Seasons; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D058666:Adrenergic beta-2 Receptor Agonists; D003692:Delayed-Action Preparations
keywords: Asthma; COPD; Long-acting beta-2 agonists; Seasonal variations; Secondary data analysis