Asthma Controller Medications for Children in Japan: Analysis of an Administrative Claims Database

Abstract

Background. Treatment and management strategies for asthma in children are generally consistent internationally, but prescription of antiasthma drugs differs among countries. The objective of this study was to examine the prescribing patterns of antiasthma drugs, particularly controller medications, in children. Methods. A retrospective cohort study was performed in children with asthma using an administrative claims database in Japan. Results. A total of 1149 preschool-age and 3226 school-age children were identified. Leukotriene receptor antagonists were prescribed for about 80% of the children. Long-acting β-agonists were prescribed for 87.6% and 59.6% of preschool-age and school-age children, respectively, whereas prescriptions of inhaled corticosteroids had lower rates of 8.2% and 16.5%, respectively. In an examination of prescriptions at 1-month intervals, a relatively high number of children were prescribed bronchodilators without anti-inflammatory agents. Conclusion. Our findings suggest that asthma care for children in Japan can be improved through changes in drug prescriptions.

Keywords: antiasthmatic agents; asthma; children; drug utilization; pharmacoepidemiology; preschool.

Figure 1.

Flow diagram of study cohort selection. Asthma controller medications included inhaled corticosteroids, combination inhalers of inhaled corticosteroids and long-acting β-agonists; leukotriene receptor antagonists; inhaled disodium cromoglycate; inhaled, oral, and transdermal long-acting β-agonists; and sustained release theophylline.

Figure 2.

Prescribing patterns for asthma controller medications by drug category in (A) preschool-age children and (B) school-age children prescribed these medications each month.

Figure 3.

Prescribing patterns of asthma controller medications by drug class in (A) preschool-age children and (B) school-age children prescribed these medications each month. Abbreviations: DSCG, inhaled disodium cromoglycate; ICS, inhaled corticosteroid; LABA, long-acting β-agonist (inhaled, oral, and transdermal); LTRA, leukotriene receptor antagonists.