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Pediatric corticosteroid use increases with poor asthma control documentation
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Children with uncontrolled or undocumented control of their asthma symptoms were more likely to receive prescriptions for both oral and inhaled corticosteroids, according to research published in Clinical Pediatrics.
“Out of all the recommendations in the NIH asthma guidelines, making sure physicians document asthma control or asthma severity is a crucial recommendation,” Michael Cabana, MD, MPH, professor of pediatrics, epidemiology and biostatistics at the University of California, San Francisco, told Infectious Diseases in Children. “This information helps form the basis for other key aspects of asthma care.”
Cabana and colleagues examined data from the 2012-2015 National Ambulatory Medical Care Survey regarding patients aged 6 to 17 years with asthma listed as their primary diagnosis.
The researchers estimated that 2.5 million pediatric office visits were made each year for asthma. Most patients were male (59.3%), aged 6 to 11 years (54.8%) and were white (73.6%). Most patients were also prescribed asthma medications at these visits (84.02%; 95% CI, 82.35%-85.07%).
According to the survey data, 72.36% of patients were prescribed short-acting beta-agonists, followed by inhaled corticosteroids (42.1%) and leukotriene modifiers (23.88%). Combined treatment with inhaled corticosteroids and long-acting beta-agonists were prescribed for 15.94% of patients.
Children were more likely to be prescribed inhaled corticosteroids when they had undocumented asthma control (OR = 1.88; 95% CI, 1.06-3.34) or uncontrolled asthma (OR = 2.66; 95% CI, 1.13-6.22). The researchers also observed an increased risk for oral corticosteroid use in children with undocumented asthma control (OR = 3.73; 95% CI, 1.57-8.87) or uncontrolled asthma (OR = 3.96; 95% CI, 1.26-12.47).
“Pediatricians should work with staff and colleagues to develop systems of care in their offices that make assessment of asthma severity and asthma control part of the office routine for children with asthma,” Cabana said. “With colleagues at primary care clinics throughout California, we have developed an asthma quality improvement collaborative to learn from each other about how to make small changes in our offices that can lead to long-term, consistently improved asthma outcomes.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.
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