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Asthma prevalence and drug prescription in asthmatic children
A Barbato1, C Panizzolo, L Biserna
1Dept of Pediatrics, University of Padova, Italy.
Insights
Pediatric asthma prevalence is higher in younger children. Treatment patterns for pediatric asthma deviate from international guidelines, with more oral corticosteroids and nebulized short-acting beta-2 agonists used in younger children.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Epidemiology
Background:
- Asthma is a common chronic respiratory disease in children.
- Understanding asthma prevalence and treatment patterns is crucial for effective pediatric care.
- International guidelines provide recommendations for asthma management in different age groups.
Purpose of the Study:
- To determine the prevalence of asthma in children aged 0-14 years.
- To assess and compare asthma treatment strategies in different pediatric age groups.
- To evaluate adherence to international asthma management guidelines.
Main Methods:
- A cross-sectional study involving 28,856 children aged 0-14 years.
- Asthma cases identified using computerized medical records (1997-1998) and validated by pediatricians.
- Data collected via medical records and interviews, stratified by age (<5 years and ≥6 years).
Main Results:
- Overall asthma prevalence was 4.7% (1,263 cases).
- Prevalence was higher in younger children (<5 years) than older children (≥6 years) for both genders.
- Treatment differed significantly: younger children received more oral corticosteroids and nebulized short-acting beta-2 agonists, contrary to guidelines.
Conclusions:
- Pediatric asthma prevalence is higher in children under 5 years old.
- Current asthma treatment practices in pediatric populations do not consistently follow international guidelines.
- Age-specific treatment strategies require re-evaluation to align with evidence-based recommendations.
Abstract:
A cross-sectional study was conducted on among 28,856 children aged from birth to 14 years to determine the prevalence of asthma and assess its treatment in a sample of asthmatic children. Children diagnosed with asthma were identified by a sensitive algorithm applied to the information stored in the computerized medical records between 1997 and 1998. Pediatricians then reviewed and validated the diagnosis. Specific information was obtained, after age stratification under 5 yrs and over 6 ys, from the medical records and by interview regarding their personal details and treatment of asthmatic patients. In all, 1,263 cases of asthma were identified (64% males) with a prevalence of 6.3% among males and 4% among females in under 5 year-olds, and 3.9% for males and 2.1% for females in over 6 year-olds. The prevalence of asthma diagnosed directly by the pediatrician was consequently higher among under 5 year-olds, in both genders, than among the older children. Contrary to the international guidelines, pediatricians prescribed more oral corticosteroids and nebulized short-acting beta-2 agonists for children under 5 ys olds than for over 6 year-olds (13.3% Vs 4.8% and 25% Vs 10.9%, respectively, p < 0.001). For the > or = 6 year-olds, the most commonly prescribed treatments were oral antihistamines (13.9% Vs 12.6%), inhaled corticosteroids via metered-dose inhaler (30.8% Vs 28.7%) and sodium cromoglycate (12.1% Vs 4.8%, p < 0.001).