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Hypoallergenic formula prescribing practices in Australia
1Department of Allergy, Immunology and Infectious Diseases, The Children's Hospital, Westmead, Australia. andrewk5@chw.edu.au
Insights
Hypoallergenic formula prescribing shows significant regional variation in Australia, with amino acid formula (AAF) use rising notably. These prescribing patterns may not align with current allergy treatment guidelines.
Area of Science:
- Pediatric Nutrition
- Allergy Management
- Health Services Research
Background:
- Hypoallergenic formulas are crucial for managing cow's milk allergy and preventing allergic diseases in infants.
- Understanding prescribing patterns of specialized infant formulas is essential for effective healthcare resource allocation and guideline adherence.
Purpose of the Study:
- To analyze the prescribing trends of hypoallergenic formulas, specifically amino acid formula (AAF) and extensively hydrolyzed formula (eHF), across Australian states and territories.
- To investigate potential correlations between formula prescribing rates and the availability of pediatric specialists.
Main Methods:
- Utilized prescription supply data from the Australian Health Insurance Commission for 2003-2004.
- Calculated prescription rates per 1000 children aged 4 years and under for each state.
- Correlated formula prescribing data with the number of pediatricians and pediatric allergists per state.
Main Results:
- A significant increase in amino acid formula (AAF) prescriptions was observed starting in 2001.
- Marked regional disparities in AAF prescribing were identified, with some states having 6-7 times higher rates than others.
- Prescribing rates of extensively hydrolyzed formula (eHF) were consistently lower than AAF across all regions.
- No clear relationship was found between AAF prescribing rates and the density of pediatricians or allergists.
Conclusions:
- Significant geographical variations in hypoallergenic formula prescribing exist in Australia, unrelated to allergic disease prevalence.
- Amino acid formula (AAF) may be frequently used as a first-line treatment for cow's milk allergy and for allergy prevention, contrary to established guidelines.
- There is a need to review Pharmaceutical Benefits Scheme guidelines and assess healthcare providers' knowledge and perceptions regarding appropriate hypoallergenic formula use.
Aim:
To gain insight into the use of hypoallergenic formula in Australia by analysis of prescribing statistics.
Methods:
Statistics on supply of amino acid and extensively hydrolyzed formula were obtained from the Health Insurance Commission web site. The number of prescriptions supplied in 2003 and 2004 per 1000 children aged 4 years and younger were calculated for each State and Territory. This was related to the numbers of paediatric physicians and paediatric allergists in each State.
Results:
There was a marked rise in the use of amino acid formula (AAF) commencing in 2001. The Australian Capital Territory, New South Wales and Victoria had 6-7 times more AAF items per 1000 children prescribed than Western Australia. This did not appear to relate to the numbers of paediatricians or paediatric allergists in each State. In all States and Territories the prescribing of extensively hydrolyzed formula was less than that of AAF.
Conclusions:
There are significant regional differences which do not appear to be related to the prevalence of allergic disease. In some States and Territories AAF may be frequently prescribed as a first line treatment for cows milk allergy and for prevention of allergic disease in contradistinction to current recommendations of the Pharmaceutical Benefits Scheme and authoritative statements and position papers. Re-examination of both the Pharmaceutical Benefit Scheme guidelines and the knowledge and perceptions of the prescribing community is indicated.
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