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Prescriptions as a proxy for asthma in children: a good choice?

  • Pharmacoepidemiology and Prescription
  • Published:
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Abstract

Purpose

Stock et al. (Eur Respir J 25:47–53, 2005) recently estimated asthma prevalence in Germany using claims data on prescriptions and hospital diagnoses and found high prevalence peaks in infants. Our objective was to critically assess and discuss various aspects of identifying children with asthma using prescription data.

Methods

We replicated the selection procedure of Stock et al. using data on 290,919 children aged 0–17 years insured in the Gmünder ErsatzKasse (GEK) in 2005. Asthma prevalence was also estimated in a sample of 17,641 children aged 0–17 years participating in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) from 2003 to 2006.

Results

In children aged 0–4 years insured in the GEK, prevalences were found to range from 11.7 to 17.7% for boys and from 7.2 to 11.1% for girls when the criteria of Stock et al. were applied. A steady decline in prevalences was observed in older age groups. Asthma prevalence estimated in the KiGGS data showed a quite different distribution. In the age group 0–4 years, prevalences were found to range from 0 to 2.6% in boys and from 0 to 1.0% in girls; in children >4 years, prevalences were found to increase with increasing age.

Conclusions

When additional validation studies were taken into account, asthma medications were found to be prescribed not only for asthma but also for other respiratory diseases. In addition, not all children with current asthma had prescriptions. We therefore conclude that asthma medications are therefore not a good proxy for the disease.

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Acknowledgments

This study was not supported by any institution. We thank the Gmünder ErsatzKasse (GEK) for providing the data.

Conflict of interests

FH and GG received funding to analyze the data of several health insurance companies, including those of the GEK.

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Authors and Affiliations

  1. Division Health Economics, Health Policy and Outcomes Research, Center for Social Policy Research, University of Bremen, Bremen, Germany

    Falk Hoffmann & Gerd Glaeske

  2. Centre for Social Policy Research, University of Bremen, Ausser der Schleifmuehle 35-37, 28203, Bremen, Germany

    Falk Hoffmann

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  1. Falk Hoffmann
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  2. Gerd Glaeske
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Correspondence to Falk Hoffmann.

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Hoffmann, F., Glaeske, G. Prescriptions as a proxy for asthma in children: a good choice?. Eur J Clin Pharmacol 66, 307–313 (2010). https://doi.org/10.1007/s00228-009-0755-z

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  • DOI: https://doi.org/10.1007/s00228-009-0755-z

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