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Prescription patterns, adherence and characteristics of non‐adherence in children with asthma in primary care
Author(s) -
Engelkes Marjolein,
Janssens Hettie M.,
Jongste Johan C.,
Sturkenboom Miriam C.J.M.,
Verhamme Katia M.C.
Publication year - 2016
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12507
Subject(s) - medicine , asthma , medical prescription , cohort , asthma medication , medical record , pediatrics , medication adherence , primary care , population , inhaled corticosteroids , cohort study , family medicine , pharmacology , environmental health
Adherence to treatment remains important for successful asthma management. Knowledge about asthma medication use and adherence in real‐life offers opportunities to improve asthma treatment in children. Objective To describe prescription patterns, adherence and factors of adherence to drugs in children with asthma. Methods Population‐based cohort study in a Dutch primary care database ( IPCI ), containing medical records of 176,516 children, aged 5–18 years, between 2000 and 2012. From asthma medication prescriptions, age, gender, seasonal and calendar year rates were calculated. Adherence was calculated using medication possession ratio ( MPR ) and ratio of controller to total asthma drug ( CTT ). Characteristics of children with high‐vs.‐low adherence were compared. Results The total asthma cohort (n = 14,303; 35,181 person‐years ( PY ) of follow‐up) was mainly treated with short‐acting β2‐agonists ( SABA ; 40 users/100 PY ) and inhaled corticosteroids ( ICS ; 32/100 PY ). Median MPR for ICS was 56%. Children with good adherence (Q4 = MPR > 87%) were younger at start of ICS , more often visited specialists and had more exacerbations during follow‐up compared to children with low adherence (Q1 = MPR < 37%). Conclusion In Dutch primary care children with asthma were mainly prescribed SABA , and ICS . Adherence to ICS was relatively low. Characteristics of children with good adherence were compatible with more severe asthma, suggesting that adherence is driven by treatment need or intensity of medical follow‐up.