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Assessment of asthma severity according to treatment steps in Japanese pediatric patients: a descriptive
Satomi Yoshida1, Shiro Tanaka2, Yuichi Adachi3
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Insights
Most Japanese children with asthma have mild-to-moderate cases, receiving lower-step treatments. Less than 10% of pediatric asthma patients required treatment for severe asthma, indicating generally mild disease prevalence.
Area of Science:
- Pediatric Pulmonology
- Epidemiology
- Health Services Research
Background:
- Japan exhibits high asthma prevalence in Asia, yet lacks comprehensive pediatric epidemiological data.
- Understanding pediatric asthma severity and treatment patterns is crucial for public health initiatives.
Purpose of the Study:
- To analyze pediatric asthma severity in Japan using a large claims database.
- To describe asthma treatment prescription patterns among children in Japan.
Main Methods:
- Utilized the JMDC claims database (2009-2015) for patients aged 2-15.
- Employed Japanese Pediatric Guidelines for Asthma (JPGL) steps to assess treatment and severity.
- Stratified data by prevalence and incidence cohorts for detailed analysis.
Main Results:
- 80-90% of pediatric asthma patients received JPGL step 1 or 2 treatment (mild-to-moderate).
- Fewer than 10% of children required step 3 or 4 treatment (severe asthma).
- Approximately 90% of treatments occurred at clinics, with a minority at hospitals.
Conclusions:
- This study provides insights into pediatric asthma severity and treatment in Japan.
- The majority of Japanese pediatric asthma patients experience mild-to-moderate disease.
- Less than 10% of pediatric asthma patients in Japan are treated for severe asthma.
Objectives:
Japan has one of the highest asthma prevalence rates in Asia; however, there is a lack of epidemiological studies on asthma among children in Japan. This study aimed to describe the severity of asthma and the prescription patterns for its treatment among pediatric patients, by using a large-scale claims database.
Methods:
The analysis datasets were extracted from the JMDC database for the period of April 1, 2009 to March 30, 2015; included records were restricted to patients between 2 and 15 years of age. The Japanese Pediatric Guidelines for the treatment and management of asthma (JPGL) steps were used as a proxy for asthma treatment and severity. We also described the characteristics of asthma in children by stratifying the prevalence and incidence cohorts by index years.
Results:
In the prevalence cohort (56% male), from 2010 to 2014, approximately 80-90% of the children received step 1 or 2 treatment, with the remainder receiving step 3 or 4 treatment, as defined by the JPGL. The majority (approximately 90%) of patients visited clinics for asthma treatment, while a minority visited hospitals.
Conclusions:
Our study showed the severity of asthma among Japanese pediatric patients, as well as their demographic characteristics, using a large-scale claims database. The majority of pediatric asthma patients received treatment for mild-to-moderate asthma, while less than 10% received treatment for severe asthma.
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