Review of prescribed treatment for children with asthma in 1990

Abstract

Objective: To review treatment prescribed to asthmatic children in Great Britain during the 12 months after publication of the first guidelines and to assess effectiveness of prophylactic treatment.

Design: Review of prescribing information from January 1990 to June 1991 in a representative sample of general practices in Great Britain with a Compufile/AAH Meditel computer.

Subjects: 17,846 children with asthma aged 4-17 years.

Main outcome measures: Numbers of children prescribed different asthma treatments; estimated use of inhaled beta agonists in those receiving prophylactic treatment.

Results: From January to December 1990, 9,362 (52.5%) children were prescribed preventive treatments. 16,211 (90.8%) children were prescribed bronchodilators of some kind. 3,055 (17.1%) were prescribed sodium cromoglycate, and the proportion decreased significantly during the study (from 19.5% (95% confidence interval 18.6% to 20.4%) to 17.2% (16.4% to 18.1%), P < 0.001, in children aged 4-11 years and from 14.9% (14.0% to 15.9%) to 11.3% (10.4% to 12.2%), P < 0.001, in those aged 12-17 during January-July 1991). 6,952 (39.0%) were prescribed inhaled steroids, and the proportion increased during the study (from 35.1% (34.0% to 36.2%) to 44.1% (43.0% to 45.2%), P < 0.001, in children aged 4-11 years and from 38.7% (37.4% to 40.0%) to 44.1% (42.7% to 45.5%), P < 0.001, in those aged 12-17 during January-July 1991). Only 1,358 of the 9,362 children (14.5%) received sufficient repeat prescriptions to suggest that they might be taking the prophylactic treatment regularly. Among these children short acting inhaled beta agonists were being used on average four to eight times a day.

Conclusions: These results are useful baseline data for audit of the impact of published clinical guidelines, particularly in terms of reducing the need for short acting inhaled beta agonists with prophylactic treatment.