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Trends in the use of inhaled corticosteroids for childhood asthma in New Zealand

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Objective

To compare the dispensed volumes and prescribed doses for inhaled corticosteroids (ICS) for children in New Zealand.

Design

Longitudinal analysis of prescribing trends using the Royal New Zealand College of General Practitioners Research Unit database and the Pharm Warehouse database of the New Zealand Health Information System.

Setting

New Zealand from 1993 to 2001.

Subjects

Children aged 0–5 years and 6–17 years.

Main outcome measures

The ratio of potency-adjusted mean daily dose of fluticasone propionate (FP) to beclomethasone (BDP) and dispensed volumes of FP, BDP and budesonide .

Results

The ratio of potency-adjusted mean daily dose of FP to BDP prescribed to children aged 0–17 years ranged from 1.22 to 1.91. With the introduction of FP, the total amount of ICS dispensed to children aged 0–5 years in New Zealand nearly doubled, when adjusted for potency.

Conclusions

The introduction of FP into New Zealand corresponds with an increase in the total amount of ICS dispensed and an increase in the adjusted daily dose prescribed.

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References

  1. The International Study of Asthma and Allergies in Childhood (ISAAC) Steering Committee (1998) Worldwide variation in prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and atopic eczema: ISAAC. Lancet 351:1225–1232

    PubMed  Google Scholar 

  2. Rasmussen F, Taylor DR, Flannery EM, Cowan JO, Greene JM, Herbison GP, et al (2002) Risk factors for hospital admission for asthma from childhood to young adulthood: a longitudinal population study. J Allergy Clin Immunol 110:220–227

    PubMed  Google Scholar 

  3. Asher MI, Barry D, Clayton T, Crane J, D'Souza W, Ellwood P, et al (2001) The burden of symptoms of asthma, allergic rhinoconjunctivitis and atopic aczema in children and adolescents in six New Zealand centres: ISAAC Phase One. N Z Med J 114:114–120

    CAS  Google Scholar 

  4. Hall J, Martin I (2002) Paediatric prescribing in New Zealand. NZFP 29:14–18

    Google Scholar 

  5. Gustafsson P, Tsanakas J, Gold M, Primhak R, Radford M, Gillies E (1993) Comparison of the efficacy and safety of inhaled fluticasone propionate 200 ug/day with inhaled beclomethasone dipropionate 400 ug/day in mild and moderate asthma. Arch Dis Child 69:206–211

    CAS  PubMed  Google Scholar 

  6. Barnes NC, Hallett C, Harris TA (1998) Clinical experience with fluticasone propionate in asthma: a meta-analysis of efficacy and systemic activity compared with budesonide and beclomethasone dipropionate at half the microgram dose or less. Respir Med 92:95–104

    CAS  PubMed  Google Scholar 

  7. Karadoc F, Karadag B, Kut A, Ersu R, Bakac S, Cebeci D, et al (2001) A comparison of the efficacy and safety of a half dose of fluticasone propionate with beclomethasone dipropionate and budesonide in childhood asthma. J Asthma 38:229–237

    Article  PubMed  Google Scholar 

  8. Fitzgerald D, Van Asperen P, Mellis C, Honner M, Smith L, Ambler G (1998) Fluticasone propionate 750 ug/day versus beclomethasone dipropionate 1500 ug/day: comparison of efficacy and adrenal function in paediatric asthma. Thorax 53:656–661

    CAS  PubMed  Google Scholar 

  9. Ferguson AC, Spier S, Manjra A, Versteegh FG, Mark S, Zhang P (1999) Efficacy and safety of high-dose inhaled steroids in children with asthma: a comparison of fluticasone propionate with budesonide. J Pediatr 134:422–427

    CAS  Google Scholar 

  10. Demedts M, Cohen R, Hawkinson R (1999) Switch to non-CFC inhaled corticosteroids: a comparative efficacy study of HFA-BDP and CFC-BDP metered-dose inhalers. Int J Clin Pract 53:331–338

    CAS  PubMed  Google Scholar 

  11. Hall J, Penrose A, Tomlin A, Reid J (2003) Differential prescribing of inhaled corticosteroids in New Zealand general practice. N Z Med J 116:(in press)

  12. Black PN, Lawrence BJ, Goh KH, Barry MS (2000) Differences in the potencies of inhaled steroids are not reflected in the doses prescribed in primary care in New Zealand. Eur J Clin Pharmacol 56:431–435

    CAS  PubMed  Google Scholar 

  13. Adams N, Bestall JM, Jones PW (2002) Fluticasone versus beclomethasone or budesonide for chronic asthma. Cochrane Database Syst Rev 1:CD002310

    PubMed  Google Scholar 

  14. Holt S, Suder A, Weatherall M, Cheng S, Shirtcliffe P, Beasley R (2001) Dose-response relation of inhaled fluticasone propionate in adolescents and adults with asthma: meta-analysis. BMJ 323:1–8

    Article  PubMed  Google Scholar 

  15. Adams N, Bestall JM, Jones PW (2002) Inhaled fluticasone at different doses for chronic asthma. Cochrane Database Syst Rev 1:CD003534

    PubMed  Google Scholar 

  16. Hofstra WB, Neijens HJ, Duiverman EJ, Kouwenberg JM, Mulder PG, Kuethe MC, et al (2000) Dose-responses over time to inhaled fluticasone propionate treatment of exercise- and methacholine-induced bronchoconstriction in children with asthma. Pediatr Pulmonol 29:415–423

    CAS  PubMed  Google Scholar 

  17. Pedersen S, Hansen OR (1995) Budesonide treatment of moderate and severe asthma in children: a dose-response study. J Allergy Clin Immunol 95:29–33

    CAS  Google Scholar 

  18. Bisgaard H, Gillies J, Groenewald M, Maden C (1999) The effect of inhaled fluticasone propionate in the treatment of young asthmatic children: a dose comparison study. Am J Respir Crit Care Med 160:126–131

    CAS  Google Scholar 

  19. Drake AJ, Howells RJ, Shield JP, Prendiville A, Ward PS, Crowne EC (2002) Symptomatic adrenal insufficiency presenting with hypoglycaemia in children with asthma receiving high dose inhaled fluticasone propionate. BMJ 324:1081–1083

    CAS  Google Scholar 

  20. Sharek PJ, Bergman DA (2000) The effect of inhaled steroids on the linear growth of children with asthma: a meta-analysis. Pediatrics 106:E8

    CAS  PubMed  Google Scholar 

  21. Van Asperen P, Mellis CM, Sly PD (2002) The role of corticosteroids in the management of childhood asthma. Med J Aust 176:169–174

    Google Scholar 

  22. Dovey SM, Tilyard MW (1996) The computer research network of the Royal New Zealand College of General Practitioners: an approach to general practice research in New Zealand. Br J Gen Pract 46:749–752

    CAS  PubMed  Google Scholar 

  23. Pethica BD, Penrose A, MacKenzie D, Hall J, Beasley R, Tilyard M (1998) Comparison of potency of inhaled beclomethasone and budesonide in New Zealand: retrospective study of computerised general practice records. BMJ 317:986–990

    CAS  PubMed  Google Scholar 

  24. Russell G (1994) Fluticasone propionate in children. Respir Med 88[Suppl A]:25–29

  25. Summary of product characteristics: flixotide inhaler 25 mcg: Glaxo Wellcome UK Ltd; 13 August 2001

  26. Lipworth BJ (1999) Systemic adverse effects of inhaled corticosteroid therapy. Arch Intern Med 159:941–955

    CAS  PubMed  Google Scholar 

  27. Barnes PJ, Jonsson B, Klim JB (1996) The costs of asthma. Eur Respir J 9:636–642

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Uppsala, Sweden

    Maria Johansson

  2. Department of General Practice, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Jason Hall

  3. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    David Reith

  4. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Pam Jackson

  5. Dunedin School of Medicine, University of Otago, Dunedin, New Zealand

    Murray Tilyard

  6. Section of Paediatrics and Child Health, Dunedin School of Medicine, 3rd Floor, Children's Pavilion, Dunedin Hospital, Great King Street, 9001, Dunedin, New Zealand

    David Reith

Authors
  1. Maria Johansson
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  2. Jason Hall
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  3. David Reith
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  4. Pam Jackson
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  5. Murray Tilyard
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Corresponding author

Correspondence to David Reith.

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Johansson, M., Hall, J., Reith, D. et al. Trends in the use of inhaled corticosteroids for childhood asthma in New Zealand. Eur J Clin Pharmacol 59, 483–487 (2003). https://doi.org/10.1007/s00228-003-0659-2

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  • DOI: https://doi.org/10.1007/s00228-003-0659-2

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