Asthma Severity and the Controller Prescription in Children at 12 Tertiary Hospitals.
OBJECTIVE
Guidelines need to be tailored to where they are applied. We aimed to describe the distinctive asthma severity profile and the pattern of controller prescription in Korean children.


METHODS
Twelve pediatric allergists from tertiary medical centers reviewed medical records of all asthmatic children who visited their clinics between September 1 and November 30 of 2013. Controller prescriptions were re-classified into 4 categories, then the prevalence of each asthma severity category and the controller prescription patterns according to asthma severity assessed by a Western (Global Initiative for Asthma, GINA) and an Asia-Pacific (Japanese Pediatric GuideLine, JPGL) guideline were evaluated.


RESULTS
A total of 840 cases were reviewed. Both GINA and JPGL revealed that 328 (39.0%) and 249 (29.6%) subjects had intermittent asthma whereas 24 (2.9%) and 21 (2.5%) subjects had severe persistent asthma, respectively. Although higher category controllers tended to be prescribed to those who had more severe asthma, there was much overlap in categories of prescribed controllers between groups with regard to asthma severities. Leukotriene receptor antagonists (LTRA) was the most frequently prescribed as a single controller (40%) or as an add-on medication (19%) in the group of asthmatic children <6 years.


CONCLUSIONS
Korean children have distinctive patterns of asthma severity and management strategies with a lower prevalence of severe asthma and a preference toward LTRA rather than low dose inhaled corticosteroids (ICS) alone or add-on long-acting beta-agonist (LABA) in the group of <6 year-old asthmatics that has not been predicted in Western countries. Thus, strategies tailored to regional situations need to be developed and recommended.
Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
Dong In
DI
Suh
Department of Pediatrics, Soonchunhyang University Hospital, Seoul, Korea.
Hyeon Jong
HJ
Yang
Department of Pediatrics, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Korea.
Bong Seong
BS
Kim
Department of Pediatrics, Gangnam CHA Hospital, Seoul, Korea.
Youn Ho
YH
Shin
Department of Pediatrics, Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Korea.
So Yeon
SY
Lee
Department of Pediatrics, Gwanghye General Hospital, Busan, Korea.
Geunhwa
G
Park
Department of Pediatrics, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
Woo Kyung
WK
Kim
Department of Pediatrics, Inje University Sanggye Paik Hospital, Seoul, Korea.
Hyo Bin
HB
Kim
Department of Pediatrics, Kangdong Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea.
Heysung
H
Baek
Department of Pediatrics, Kangwon National University Hospital, Chuncheon, Korea.
Ja Kyoung
JK
Kim
Department of Pediatrics, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea. jintackk@catholic.ac.kr.
Jin Tack
JT
Kim
Department of Pediatrics, Inha University Hospital, Incheon, Korea.|Environmental Health Center for Allergic Rhinitis, Ministry of Environment, Korea. dhnlim@naver.com.
Dae Hyun
DH
Lim
Asthma; Leukotriene antagonists; Republic of Korea; child; guideline