By Lilian Anekwe
GP prescribing practices when managing children and young teenagers with asthma ‘does not always correspond to recommendations of asthma management guidelines’ according to a UK observational study.
A study of 10,000 children 14 and under with asthma or recurrent wheezing recorded in the General Practice Research Database between September 2006 and February 2007 found that 91% had a prescription for an inhaled steroid – as recommended by guidance.
But 1.5% of under fives and 3.2%% of children aged 5-14 were prescribed high doses of ICS alone at doses of up to 800mcg a day – a dose for which the drug is not licensed – during the previous six months
Combination inhaled steroid-LABA therapy was prescribed for 7% of patients, most of whom were classified as having intermittent or mild persistent asthma. Of children with severe asthma, none were prescribed additional therapy.
Dr Mike Thomas, a GP in Minchinhampton, Gloucestershire and a hospital practitioner in asthma, led the study and concluded: ‘Physician classifications of asthma severity did not always correspond to guideline recommendations, as leukotriene receptor antagonists were rarely used and high-dose inhaled steroid or add-on LABA was prescribed, even in intermittent and mild disease.’
BMC Pulmonary Medicine 2010, 10:29
Child asthma guidance not reflected in practice