title: Recurrent Wheezing in Infants: A Population-Based Study.
abstract: Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data. Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms. A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms. In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care.
authors.affiliation: From the Merck Sharp & Dohme, Paris (MB, VL, CC-V, LL); HESPER Claude Bernard University, Lyon (MB, LL, MG, EVG); Pediatric Pulmonology, AP-HP, Necker Enfants Malades Hospital, Paris; Paris Descartes University, Paris, France (JDB); Pediatric Medicine, Caen University Hospital, Caen (JB); Pediatric Noninvasive Ventilation and Sleep Unit, Necker University Hospital, Paris (BF); Paris Descartes University, Paris (BF); ESSEC Business School, Paris (GDP); and Respiratory Medicine, Croix Rousse University Hospital, Lyon, France (EVG).
authors.forename: Manon
authors.initials: M
authors.lastname: Belhassen
authors.forename: Jacques
authors.initials: J
authors.lastname: De Blic
authors.forename: Laurent
authors.initials: L
authors.lastname: Laforest
authors.forename: Valérie
authors.initials: V
authors.lastname: Laigle
authors.forename: Céline
authors.initials: C
authors.lastname: Chanut-Vogel
authors.forename: Liliane
authors.initials: L
authors.lastname: Lamezec
authors.forename: Jacques
authors.initials: J
authors.lastname: Brouard
authors.forename: Brigitte
authors.initials: B
authors.lastname: Fauroux
authors.forename: Gérard
authors.initials: G
authors.lastname: de Pouvourville
authors.forename: Marine
authors.initials: M
authors.lastname: Ginoux
authors.forename: Eric
authors.initials: E
authors.lastname: Van Ganse
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000627:therapeutic use; D004333:Drug Administration Routes; D005260:Female; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D008297:Male; D012008:Recurrence; D012135:Respiratory Sounds / Q000503:physiopathology*; D012720:Severity of Illness Index
chemical_list: D000305:Adrenal Cortex Hormones; D000900:Anti-Bacterial Agents; D001993:Bronchodilator Agents