title: Prescription patterns of inhaled corticosteroids for preschool children--A Norwegian register study.
abstract: BACKGROUND
  Although guidelines for treatment of wheeze and asthma in preschool children are available, symptoms are overlapping and it may be difficult to decide which children should be given inhaled corticosteroids (ICS). Previous studies suggest an inappropriate prescription pattern of ICS in this age group. We studied time trends of ICS use in preschool children in Norway during 2004-2013 by age, gender and physician specialty, and the persistence of ICS use during preschool years.
  
  
  METHODS
  Data were drawn from the Norwegian Prescription Database. The study population consisted of children ≤5 years who were prescribed ICS (alone or in combination) during 2004-2013.
  
  
  RESULTS
  The one-year prevalence of ICS use was generally high, and increased from 2004 to 2010, but decreased thereafter. The prevalence was highest in 2-year-olds (boys 12.9% and girls 9.3% in 2010) and declined by age, and higher among boys in all ages. 40-50% of ICS users received only one prescription per year. The share of children with persistent use of ICS over several preschool years was low, irrespective of the age at the first prescription. The majority of prescriptions were given by general practitioners, increasing during the study period.
  
  
  CONCLUSIONS
  The prevalence of ICS prescription for preschool children was high, but with low persistence, suggesting that ICS are frequently given for intermittent asthma-like symptoms. Asthma guidelines suggest a restrictive use of ICS during the first years of life, and the results may call for actions to better implement these guidelines.
authors.affiliation: Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.|Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Øymar
authors.affiliation: Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway.
authors.forename: Ingvild Bruun
authors.initials: IB
authors.lastname: Mikalsen
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Kari
authors.initials: K
authors.lastname: Furu
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Wenche
authors.initials: W
authors.lastname: Nystad
authors.affiliation: Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway.
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Karlstad
mesh_terms: D000280:Administration, Inhalation; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D002675:Child, Preschool; D016208:Databases, Factual; D004363:Drug Utilization / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D007223:Infant; D007231:Infant, Newborn; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D009664:Norway; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D012042:Registries
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents
keywords: asthma: treatment and epidemiology; epidemiology: epidemiology of asthma; pharmacology: corticosteroids