As family doctors are ignoring prescribing guidelines children in the UK are not receiving the best drug treatment for asthma, according to an article published in the Archives of Disease in Childhood.

There are approximately one million children in the UK who suffer from asthma. About a third of them visit their doctor when they are aged 5-13.

In this study, the scientists calculated the number of asthma drug prescriptions issued by doctors by collecting national data – the data focused on doctors working in the community during the period 2000-2006 in the UK. They then matched those figures with guidance issued by the BTS (British Thoracic Society), which was updated in 2005 – it includes the most suitable medical treatments for children with asthma.

The guidance disapproves of the use of bronchodilator syrups – designed to open up the airways – because their effect is systemic instead of targeted. Moreover, bronchodilator syrups to do control asthma very well.

Even though bronchodilator syrup prescriptions dropped by 60%, the researchers noticed that in 2006 over 121,000 such prescriptions had been issued. The use of LABAs (long acting beta agonists) had almost doubled – despite concerns about the effects these types of medications might have on children.

The researchers were surprised to find that the prescribing of combination inhalers, which contain a steroid and a LABA went up 7-fold. According to the BTS guidance, combination inhalers should only be used when suitable dose steroid inhalers fail to control the asthma properly (persistent asthma). Between 5% and 10% of children with asthma suffer from persistent asthma, say the writers.

The writers doubt that the changes in prescribing practices are due to an increase in asthma prevalence. They also doubt that they are attributable to population changes – because the under-18 population in the UK went down during the period 2000-2006.

“Paediatric prescribing of asthma drugs in the UK : are we sticking to the guideline?”
Online First Arch Dis Child 2007; doi: 10.1136/adc.2007.119835
Simon Aaron Cohen, Jonny Taitz and Adam Jaffe
Click here to view abstract online

Written by: Christian Nordqvist