Variabilidad e idoneidad del tratamiento antiasmático en pediatría de atención primaria

OBJECTIVE: To analyse the use patterns and the characteristics of anti-asmathic prescriptions in pediatric primary health care. DESIGN: Observational and retrospective study. LOCATION: Pediatric primary health care, Asturias, Spain. PARTICIPANTS: Drug prescriptions in respiratory diseases in children (< 14 years old) during 2011. PRINCIPAL MEASUREMENTS: Data obtained from the billing database of the Regional Health Service of Asturias and analysed by sanitary district and primary health centres, calculating the number of DDD/1.000 children/day (DHD). Clinical records audit in 6 paediatric surgeries of sanitary district V to evaluate the suitability of the drug prescriptions to the current recommendations. RESULTS: The main group were bronchodilators (17.14 DHD) with predominance of the inhaled route (14 DHD). We observe more use of inhaled corticoids (4.83 DHD), with an important use of fluticasone. We considered un-suitable 94.3% oral bronchodilators, and > 50% of mepiramine prescriptions. We registered off-label prescriptions, 17.8% of them were about oral salbutamol, being used in children < 2 years old. CONCLUSIONS: The use of anti-asthmatic drugs in our region is high, maybe it's related to the asthma prevalence. We observed variability between sanitary districts and health centres. The prescription patterns are closed to the current recommendation, except in the case of oral bronchodilators.