A retrospective observational study comparing rescue medication use in children on combined versus separate long-acting beta-agonists and corticosteroids

H. Elkout, J. S. McLay, C. R. Simpson, P. J. Helms

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Abstract

Background Data on the efficacy and safety of long-acting beta 2-agonists (LABA) in children are limited, and current guidelines recommend that LABA always be used with inhaled corticosteroids (ICS).

Objective To compare asthma control, assessed by rescue medications use, in children prescribed LABA and ICS as a fixed-dose combination (LABA/ICS) or concurrently via separate inhalers (LABA+ICS).

Methods Retrospective observational study of asthma medication prescribed to children aged 0-18 years registered with 40 primary care practices for the years 2002-6. Asthma control, reflected by requirement for oral corticosteroids (OCS) and/or six or more short-acting beta 2-agonist (SABA) canisters per year, was assessed for children prescribed LABA/ICS or LABA+ICS.

Results 10 454 (8%) of all registered children received at least one prescription for asthma medication over the study period. Prescribing of LABA/ICS increased significantly, with a concomitant decrease in prescribing of LABA+ICS. Use of OCS increased by 60%, with the lowest use in children prescribed only SABA and highest use in those prescribed LABA. Children prescribed LABA/ICS were significantly less likely than those prescribed LABA+ICS to require OCS rescue therapy and or >6 SABA inhalers a year (OR 1.6; 95% CI 1.1 to 2.2; p=0.04 and OR 1.7; 95% CI 1.1 to 2.5; p=0.005, respectively, for the years 2005-6).

Conclusions The results of this retrospective observational study suggest that children prescribed fixed-dose LABA-and-ICS combination devices achieve better asthma control, as reflected in reduced requirements for SABA and reduced courses of OCS than equivalent doses in separate devices.

Original languageEnglish
Pages (from-to)817-821
Number of pages5
JournalArchives of Disease in Childhood
Volume95
Issue number10
DOIs
Publication statusPublished - Oct 2010

Keywords

  • salmeterol/fluticasone propionate combination
  • inhaled corticosteroids
  • fluticasone propionate
  • single inhaler
  • MU-G
  • resource utilization
  • persistent asthma
  • double-blind
  • controller therapies
  • controlled trial

Cite this

A retrospective observational study comparing rescue medication use in children on combined versus separate long-acting beta-agonists and corticosteroids. / Elkout, H.; McLay, J. S.; Simpson, C. R.; Helms, P. J.

In: Archives of Disease in Childhood, Vol. 95, No. 10, 10.2010, p. 817-821.

Research output: Contribution to journalArticle

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abstract = "Background Data on the efficacy and safety of long-acting beta 2-agonists (LABA) in children are limited, and current guidelines recommend that LABA always be used with inhaled corticosteroids (ICS).Objective To compare asthma control, assessed by rescue medications use, in children prescribed LABA and ICS as a fixed-dose combination (LABA/ICS) or concurrently via separate inhalers (LABA+ICS).Methods Retrospective observational study of asthma medication prescribed to children aged 0-18 years registered with 40 primary care practices for the years 2002-6. Asthma control, reflected by requirement for oral corticosteroids (OCS) and/or six or more short-acting beta 2-agonist (SABA) canisters per year, was assessed for children prescribed LABA/ICS or LABA+ICS.Results 10 454 (8{\%}) of all registered children received at least one prescription for asthma medication over the study period. Prescribing of LABA/ICS increased significantly, with a concomitant decrease in prescribing of LABA+ICS. Use of OCS increased by 60{\%}, with the lowest use in children prescribed only SABA and highest use in those prescribed LABA. Children prescribed LABA/ICS were significantly less likely than those prescribed LABA+ICS to require OCS rescue therapy and or >6 SABA inhalers a year (OR 1.6; 95{\%} CI 1.1 to 2.2; p=0.04 and OR 1.7; 95{\%} CI 1.1 to 2.5; p=0.005, respectively, for the years 2005-6).Conclusions The results of this retrospective observational study suggest that children prescribed fixed-dose LABA-and-ICS combination devices achieve better asthma control, as reflected in reduced requirements for SABA and reduced courses of OCS than equivalent doses in separate devices.",
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T1 - A retrospective observational study comparing rescue medication use in children on combined versus separate long-acting beta-agonists and corticosteroids

AU - Elkout, H.

AU - McLay, J. S.

AU - Simpson, C. R.

AU - Helms, P. J.

PY - 2010/10

Y1 - 2010/10

N2 - Background Data on the efficacy and safety of long-acting beta 2-agonists (LABA) in children are limited, and current guidelines recommend that LABA always be used with inhaled corticosteroids (ICS).Objective To compare asthma control, assessed by rescue medications use, in children prescribed LABA and ICS as a fixed-dose combination (LABA/ICS) or concurrently via separate inhalers (LABA+ICS).Methods Retrospective observational study of asthma medication prescribed to children aged 0-18 years registered with 40 primary care practices for the years 2002-6. Asthma control, reflected by requirement for oral corticosteroids (OCS) and/or six or more short-acting beta 2-agonist (SABA) canisters per year, was assessed for children prescribed LABA/ICS or LABA+ICS.Results 10 454 (8%) of all registered children received at least one prescription for asthma medication over the study period. Prescribing of LABA/ICS increased significantly, with a concomitant decrease in prescribing of LABA+ICS. Use of OCS increased by 60%, with the lowest use in children prescribed only SABA and highest use in those prescribed LABA. Children prescribed LABA/ICS were significantly less likely than those prescribed LABA+ICS to require OCS rescue therapy and or >6 SABA inhalers a year (OR 1.6; 95% CI 1.1 to 2.2; p=0.04 and OR 1.7; 95% CI 1.1 to 2.5; p=0.005, respectively, for the years 2005-6).Conclusions The results of this retrospective observational study suggest that children prescribed fixed-dose LABA-and-ICS combination devices achieve better asthma control, as reflected in reduced requirements for SABA and reduced courses of OCS than equivalent doses in separate devices.

AB - Background Data on the efficacy and safety of long-acting beta 2-agonists (LABA) in children are limited, and current guidelines recommend that LABA always be used with inhaled corticosteroids (ICS).Objective To compare asthma control, assessed by rescue medications use, in children prescribed LABA and ICS as a fixed-dose combination (LABA/ICS) or concurrently via separate inhalers (LABA+ICS).Methods Retrospective observational study of asthma medication prescribed to children aged 0-18 years registered with 40 primary care practices for the years 2002-6. Asthma control, reflected by requirement for oral corticosteroids (OCS) and/or six or more short-acting beta 2-agonist (SABA) canisters per year, was assessed for children prescribed LABA/ICS or LABA+ICS.Results 10 454 (8%) of all registered children received at least one prescription for asthma medication over the study period. Prescribing of LABA/ICS increased significantly, with a concomitant decrease in prescribing of LABA+ICS. Use of OCS increased by 60%, with the lowest use in children prescribed only SABA and highest use in those prescribed LABA. Children prescribed LABA/ICS were significantly less likely than those prescribed LABA+ICS to require OCS rescue therapy and or >6 SABA inhalers a year (OR 1.6; 95% CI 1.1 to 2.2; p=0.04 and OR 1.7; 95% CI 1.1 to 2.5; p=0.005, respectively, for the years 2005-6).Conclusions The results of this retrospective observational study suggest that children prescribed fixed-dose LABA-and-ICS combination devices achieve better asthma control, as reflected in reduced requirements for SABA and reduced courses of OCS than equivalent doses in separate devices.

KW - salmeterol/fluticasone propionate combination

KW - inhaled corticosteroids

KW - fluticasone propionate

KW - single inhaler

KW - MU-G

KW - resource utilization

KW - persistent asthma

KW - double-blind

KW - controller therapies

KW - controlled trial

U2 - 10.1136/adc.2009.179069

DO - 10.1136/adc.2009.179069

M3 - Article

VL - 95

SP - 817

EP - 821

JO - Archives of Disease in Childhood

JF - Archives of Disease in Childhood

SN - 0003-9888

IS - 10

ER -