European Journal of Clinical Pharmacology

, Volume 62, Issue 1, pp 51–55 | Cite as

The gap between evidence-based medicine and daily practice in the management of paediatric asthma. A pharmacy-based population study from The Netherlands

  • Tjalling W. de Vries
  • Hilde Tobi
  • Eric Schirm
  • Paul van den Berg
  • Eric J. Duiverman
  • Lolkje T. W. de Jong-van den Berg
Pharmacoepidemiology and Prescription

Abstract

Objective

We evaluated the adherence to national guidelines for the treatment of asthma in childhood.

Methods

Prescriptions for anti-asthma medication for children (0–14 years of age) were retrieved from the InterAction DataBase (IABD) for the year 2002. These were compared with recommendations found in national guidelines.

Results

Anti-asthma medication was prescribed for 3,612 children (5%) of the paediatric population. Inhaled medication was prescribed for 3,554 (98%) children. In 1,940 of 1,993 (97%) of the children under the age of 6 years pressurised metered dose inhalers (pMDIs) were given. Short-acting β2-agonists had not been prescribed in the previous 2-year period in 559 children (15%), 543 children older than 8 years (36%) did not receive a prescription for a dry powder inhalator and 239 children (7%) had more than one type of inhalator. Long-acting β2-agonists were prescribed in 396 children, but without concomitant inhaled corticosteroids (ICS) in 35 children (9%).

Conclusions

Inhalation therapy as the method of choice in asthma therapy and the use of pMDI in preschool children are widely accepted in the Netherlands. Not all children have been prescribed bronchodilators. Some children have more than one type of inhaler device and others use long-acting β2-agonists not in combination with ICS. Although national and international guidelines about the treatment of asthma in children offer evidence-based advice, important principles are not followed. Effective interventions aimed at implementing existing guidelines into daily practice are urgently needed.

Keywords

Asthma Adherence Pharmacy Guidelines 

Abbreviations

IADB

InterAction DataBase

pMDI

Pressurised metered dose inhalator

DPI

Dry powder inhalator

SABA

Short-acting β2-agonist

LABA

Long-acting β2-agonist

OTC

Over-the-counter

LTRA

Leucotriene receptor antagonist

ATC

Anatomical Therapeutic Chemical classification of drugs

Notes

Acknowledgement

We thank Dr. J. Collins for reviewing the English.

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Copyright information

© Springer-Verlag 2005

Authors and Affiliations

  • Tjalling W. de Vries
    • 1
  • Hilde Tobi
    • 2
  • Eric Schirm
    • 2
  • Paul van den Berg
    • 2
  • Eric J. Duiverman
    • 3
  • Lolkje T. W. de Jong-van den Berg
    • 2
  1. 1.Department of PaediatricsMedical Centre LeeuwardenLeeuwardenThe Netherlands
  2. 2.Department of Social Pharmacy, Pharmacoepidemiology and PharmacotherapyGroningen University Institute for Drug Exploration (GUIDE)GroningenThe Netherlands
  3. 3.Paediatric PulmonologyBeatrix Children Hospital, University Hospital GroningenGroningenThe Netherlands

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