Patterns of asthma medication use: early asthma therapy initiation and asthma outcomes at age 8

Authors

  • Ellen S. Koster,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    Search for more papers by this author
  • Alet H. Wijga,

    1. Center for Prevention and Health Services Research, National Institute for Public Health and Environment, Bilthoven, The Netherlands
    Search for more papers by this author
  • Mira G. P. Zuidgeest,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    Search for more papers by this author
  • Svetlana V. Belitser,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    Search for more papers by this author
  • Jan A. M. Raaijmakers,

    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    Search for more papers by this author
  • Gerard H. Koppelman,

    1. Department of Paediatric Pulmonology and Paediatric Allergology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    Search for more papers by this author
  • Dirkje S. Postma,

    1. Department of Pulmonology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
    Search for more papers by this author
  • Bert Brunekreef,

    1. Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
    2. Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
    Search for more papers by this author
  • Johan C. de Jongste,

    1. Division of Paediatric Respiratory Medicine, Sophia Children's Hospital, Erasmus Medical Center, Rotterdam, The Netherlands
    Search for more papers by this author
  • Anke-Hilse Maitland-van der Zee

    Corresponding author
    1. Division of Pharmacoepidemiology & Pharmacotherapy, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands
    • Division of Pharmacoepidemiology and Pharmacotherapy, Faculty of Science, Utrecht University, P.O. Box 80082, 3508 TB Utrecht, The Netherlands.
    Search for more papers by this author

  • This article was published online on April 29, 2010. An error was subsequently identified on the presentation of one of the authors name. This notice is included in the online and print versions to indicate that both have been corrected on May 21, 2010.

Abstract

Wheeze has many underlying pathophysiologies in childhood, but is the main reason for anti-asthma drugs prescription. This study was conducted to describe asthma medication use patterns among children in their first eight years of life. Longitudinal medication use data from 777 children participating in the PIAMA study were used. Medication patterns were described for four groups that started therapy before the third birthday, when the peak in prescriptions occurred in our cohort; short-acting β-agonists (SABA), inhaled corticosteroids (ICS), SABA + ICS or none of these. One third (n = 255) of the children received a first SABA or ICS prescription before age 8. Only three children (1.2%) used medication continuously during follow-up. Of the children who started SABA, 53.8% discontinued within 1–2 years. Of the children who started ICS before age 3, 42.1% discontinued within 1–2 years and 31.6% received additional SABA. 41.5% of the children who started SABA + ICS used this short-term (≤1–2 years) and 21.5% long-term (≥3 years). Fifteen percent of children who did not start asthma therapy in their first 3 years of life did receive prescriptions between age 3 and 8. Children prescribed SABA + ICS before age 3 had the highest prevalence of hyper responsiveness at age 8, and similar prevalence of atopy as the other groups. Asthma medication is prescribed frequently in the first 8 years of life, particularly before age 3, and only few children use it continuously. ICS and SABA prescription occurs especially in those who were more likely to develop signs of asthma at age 8. Copyright © 2010 John Wiley & Sons, Ltd.

Ancillary