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Patterns of topical corticosteroids prescriptions in children with asthma
Author(s) -
Arabkhazaeli Ali,
Vijverberg Susanne J. H.,
Lee Maaike,
Ent Cornelis K.,
BruijnzeelKoomen Carla A.,
BruinWeller Marjolein S.,
Raaijmakers Jan A.,
Maitlandvan der Zee Anke H.
Publication year - 2018
Publication title -
pediatric dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.542
H-Index - 73
eISSN - 1525-1470
pISSN - 0736-8046
DOI - 10.1111/pde.13455
Subject(s) - medicine , medical prescription , corticosteroid , concordance , asthma , pharmacy , incidence (geometry) , atopic dermatitis , pediatrics , confidence interval , population , dermatology , family medicine , pharmacology , environmental health , physics , optics
Objectives To study topical corticosteroid use in Dutch asthmatic children using pharmacy dispensing data and to assess whether Dutch physicians prescribe topical corticosteroids in this population according to clinical guidelines. Methods Medication histories of children using asthma medication were extracted from the pharmacy dispensing system in 100 Dutch community pharmacies. The incidence rate and the potency of topical corticosteroid prescriptions per age were assessed. The topical corticosteroid incidence rates of the different age groups were compared using the Pearson chi‐square test. Generalized linear models were used to study the prescription behavior of general practitioners and atopic dermatitis‐related specialists regarding different classes of topical corticosteroids. Results Thirty percent of the infants received a topical corticosteroid prescription, compared with 15%‐18% of the children aged 4 and older. Similarly, the mean number of topical corticosteroid prescriptions in infants was 2.2 per year, compared with 1.6‐1.9 in children aged 4 and older. In concordance with the clinical guidelines, we observed that atopic dermatitis‐related specialists more often prescribed first prescriptions of potent and very potent topical corticosteroids than general practitioners (relative risk = 2.55, 95% confidence interval = 1.79‐3.63). Statistically significant differences ( P < .01) were found between potencies of prescribed topical corticosteroids. Conclusion Younger children receive more topical corticosteroid prescriptions than children aged 4 and older, and there is a statistically significantly higher prescription rate of topical corticosteroid for infants. Sometimes general practitioners do not follow guidelines and prescribe more‐potent topical corticosteroids without a prior prescription of the same potency by a specialist.