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Trends in medication use for asthma in school-entry children in the Australian Capital Territory, 2000–2005

Christine B Phillips, Helen Toyne, Karen Ciszek, Robyn G Attewell and Marjan Kljakovic
Med J Aust 2007; 187 (1): 10-13.

Summary

Objective: To analyse trends in asthma medications used by school-entry children whose parents report they have asthma.

Design and setting: Annual cross-sectional study of all school-entry children (about 4400 each year) in the Australian Capital Territory in 2000–2005, by means of a questionnaire for parents on child health status and medication use; and a cross-sectional study of asthma prescriptions for children aged 5 years obtained from the Medicare Australia database for 2002–2005.

Participants: All school-entry children in the ACT with parent-reported asthma (numbers in the years 2000–2005 ranged between 435 and 589).

Main outcome measures: Changes in the use of different medications; changes in delivery devices for asthma; changes in the potency of inhaled fluticasone.

Results: Response rates to kindergarten health screening were in the range 85%–89% for 2000–2005. Parent-reported asthma prevalence ranged from 11% to 15%. Each year, around 35% of children with asthma (age range, 4–6 years) used inhaled corticosteroids. An increase in the use of fluticasone (from 11% to 33% of children with asthma) was offset by decreases in beclomethasone use (from 14% to 3%) and budesonide (from 14% to 4%). Use of cromoglycate and nedocromil fell from 46% to 16%. Nebuliser use decreased (from 45% to 20%), while the use of spacer devices increased (from 70% to 83%). Use of combined salmeterol/fluticasone increased from 8% (in 2002) to 20% (in 2005) of children with parent-reported asthma. These trends were mirrored in Medicare Australia data for 5-year-old children in the ACT.

Conclusions: There was marked volatility in the types of asthma medication used over the 6 years. Reciprocal trends leading to increased use of spacers and decreased use of nebulisers are in accord with national guidelines for better asthma management. The increasing use of products containing a combination of salmeterol and fluticasone requires ongoing monitoring.

  • Christine B Phillips1
  • Helen Toyne1
  • Karen Ciszek1
  • Robyn G Attewell2
  • Marjan Kljakovic1

  • 1 Academic Unit of General Practice and Community Health, Australian National University, Canberra, ACT.
  • 2 Covance Pty Ltd, Canberra, ACT.


Acknowledgements: 

We are grateful to the maternal and child nurses from ACT Health who undertook the kindergarten health screening, Dr Clare McGuiness for advice, and Ms Maxine Robinson and staff of the Drug Utilisation Sub-Committee of the Pharmaceutical Benefits Advisory Committee, Australian Government Department of Health and Ageing for assistance with accessing Medicare Australia data.

Competing interests:

Covance Pty Ltd has ongoing consulting agreements with Boehringer Ingelheim, AstraZeneca and GlaxoSmithKline Australia. Robyn Attewell has been involved in research in primary care and clinical settings under these contracts. Her contribution to this article was not related to these contracts, and was under a separate consulting contract with ACT Health and Community Care.

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