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Spirometry monitoring in asthmatic children in Lombardy Region, Italy
OBJECTIVES: To evaluate the diagnostic and therapeutic approaches in a cohort of asthmatic children before and after starting drug therapy. METHODS: Data were retrieved from administrative databases of the Lombardy Region. The study population was composed of 78 184 children born in the Lombardy Reg...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203055/ https://www.ncbi.nlm.nih.gov/pubmed/30397670 http://dx.doi.org/10.1136/bmjpo-2018-000334 |
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author | Casartelli, Pietro Clavenna, Antonio Cartabia, Massimo Bortolotti, Angela Fortino, Ida Merlino, Luca Biondi, Andrea Bonati, Maurizio |
author_facet | Casartelli, Pietro Clavenna, Antonio Cartabia, Massimo Bortolotti, Angela Fortino, Ida Merlino, Luca Biondi, Andrea Bonati, Maurizio |
author_sort | Casartelli, Pietro |
collection | PubMed |
description | OBJECTIVES: To evaluate the diagnostic and therapeutic approaches in a cohort of asthmatic children before and after starting drug therapy. METHODS: Data were retrieved from administrative databases of the Lombardy Region. The study population was composed of 78 184 children born in the Lombardy Region in 2002 and followed until their 10th birthday. Children with at least one antiasthmatic drug prescription per year (with the exclusion of nebulised suspension/solution formulations) in 2 consecutive years and at least one antiasthmatic drug prescription after the fifth birthday were identified as potential asthmatics (PA). Each PA was monitored for a period starting from 12 months before and ending 24 months after the first prescription (index prescription, IP). During the monitoring period antiasthmatic drug prescriptions were analysed, as well as spirometry and/or specialist visits. RESULTS: A total of 59 975 children (76.7%) received ≥1 prescription of antiasthmatic drugs in their first 10 years of life, and 4475 (5.7%) were identified as PAs. In all, 24% of PAs started with short-acting β2-agonists (SABA), 23% with inhaled corticosteroids (ICS) and 20% with SABA+ICS. A total of 33% of PAs had at least one prescription for specialist visit/spirometry: 11% before and 28% after the IP. The factors associated with a greater likelihood of receiving visit/spirometry prescriptions were local health unit of residence, age and high use of asthma drugs. CONCLUSIONS: Despite international guideline recommendations, spirometry monitoring is still underused in asthmatic children, even in subjects who initiated pharmacological treatment and therefore need an airway function evaluation. Moreover, the choice of drug therapy appears not always rational, since one out of four children were commenced on ICS as monotherapy. |
format | Online Article Text |
id | pubmed-6203055 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-62030552018-11-05 Spirometry monitoring in asthmatic children in Lombardy Region, Italy Casartelli, Pietro Clavenna, Antonio Cartabia, Massimo Bortolotti, Angela Fortino, Ida Merlino, Luca Biondi, Andrea Bonati, Maurizio BMJ Paediatr Open Therapeutics OBJECTIVES: To evaluate the diagnostic and therapeutic approaches in a cohort of asthmatic children before and after starting drug therapy. METHODS: Data were retrieved from administrative databases of the Lombardy Region. The study population was composed of 78 184 children born in the Lombardy Region in 2002 and followed until their 10th birthday. Children with at least one antiasthmatic drug prescription per year (with the exclusion of nebulised suspension/solution formulations) in 2 consecutive years and at least one antiasthmatic drug prescription after the fifth birthday were identified as potential asthmatics (PA). Each PA was monitored for a period starting from 12 months before and ending 24 months after the first prescription (index prescription, IP). During the monitoring period antiasthmatic drug prescriptions were analysed, as well as spirometry and/or specialist visits. RESULTS: A total of 59 975 children (76.7%) received ≥1 prescription of antiasthmatic drugs in their first 10 years of life, and 4475 (5.7%) were identified as PAs. In all, 24% of PAs started with short-acting β2-agonists (SABA), 23% with inhaled corticosteroids (ICS) and 20% with SABA+ICS. A total of 33% of PAs had at least one prescription for specialist visit/spirometry: 11% before and 28% after the IP. The factors associated with a greater likelihood of receiving visit/spirometry prescriptions were local health unit of residence, age and high use of asthma drugs. CONCLUSIONS: Despite international guideline recommendations, spirometry monitoring is still underused in asthmatic children, even in subjects who initiated pharmacological treatment and therefore need an airway function evaluation. Moreover, the choice of drug therapy appears not always rational, since one out of four children were commenced on ICS as monotherapy. BMJ Publishing Group 2018-10-09 /pmc/articles/PMC6203055/ /pubmed/30397670 http://dx.doi.org/10.1136/bmjpo-2018-000334 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Therapeutics Casartelli, Pietro Clavenna, Antonio Cartabia, Massimo Bortolotti, Angela Fortino, Ida Merlino, Luca Biondi, Andrea Bonati, Maurizio Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title | Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title_full | Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title_fullStr | Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title_full_unstemmed | Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title_short | Spirometry monitoring in asthmatic children in Lombardy Region, Italy |
title_sort | spirometry monitoring in asthmatic children in lombardy region, italy |
topic | Therapeutics |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6203055/ https://www.ncbi.nlm.nih.gov/pubmed/30397670 http://dx.doi.org/10.1136/bmjpo-2018-000334 |
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