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Clinical Profile and Prescribing Patterns of Therapy in Children with Bronchial Asthma in a Rural Site in the

Gayle Therese K Gonzales-Javier1, Leonila F Dans1, Kristine Tanega-Aliling1

  • 1Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila.

Acta Medica Philippina
|February 3, 2025
PubMed

Insights

Pediatric asthma care in the Philippines shows poor adherence to GINA guidelines. Overuse of short-acting beta-agonists (SABA) and underuse of inhaled corticosteroids (ICS) were noted, impacting asthma control.

Area of Science:

  • Pediatric pulmonology
  • Public health
  • Clinical quality improvement

Background:

  • Bronchial asthma is a prevalent chronic childhood illness in primary care.
  • Assessing adherence to asthma clinical practice guidelines indicates the quality of care within universal health care systems.
  • The Philippines' primary care setting faces challenges in managing pediatric asthma effectively.

Purpose of the Study:

  • To characterize the clinical profile of pediatric patients diagnosed with bronchial asthma.
  • To evaluate current asthma treatment prescription patterns in a primary care environment.
  • To assess adherence to Global Initiative for Asthma (GINA) guidelines in pediatric asthma management.

Main Methods:

  • Retrospective cohort study utilizing electronic medical records from the Philippine Primary Care Studies (PPCS).
  • Inclusion criteria: Patients under 19 years old diagnosed with asthma between April 2019 and March 2021.
  • Quality indicators were derived from the 2019 Global Initiative for Asthma (GINA) Guidelines.

Main Results:

  • A cohort of 240 children with asthma (mean age 6 years) was analyzed, showing a slight male predominance.
  • High prescription rates for short-acting beta-agonists (SABA), both inhaled (93.3%) and oral (27.5%), were observed.
  • Underutilization of inhaled corticosteroids (ICS) (5.8%) and overuse of SABA-only treatment (especially in children ≥6 years) were significant findings.
  • Antibiotics were prescribed to 71.3% of patients, often without clear indication according to GINA guidelines.

Conclusions:

  • The study identified suboptimal adherence to GINA guidelines by rural health physicians in managing pediatric asthma.
  • Key issues include the overuse of SABA and underuse of ICS, indicating a need for improved asthma control strategies.
  • Findings highlight critical gaps in pediatric asthma care quality within the studied primary care setting.
Abstract

Keywords:
adherencebronchial asthmaprescription patterns

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