Prescribing of asthma drugs for children 2004–2015

Mikalsen, Ingvild Bruun; Karlstad, Øystein; Furu, Kari; Øymar, Knut

doi:10.4045/tidsskr.17.0227

Cited by 5 publications

(7 citation statements)

References 11 publications

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“…Due to various effect estimates, the results from the Poisson regression analyses (RR) and the ZINB models (IRR) are not directly comparable. However, most Norwegian children receive only one or few prescriptions and with low persistence, suggesting that ICS are frequently given for intermittent asthma‐like symptoms …”

Section: Discussionmentioning

confidence: 99%

“…A 20% prescription rate was found in Italian children 2 to 4 years of age, compared with 10% in Norway and 5% in UK and the Netherlands . There are also substantial regional differences within countries, both in Norway and other countries . Many children fill only one prescription, indicating that ICS are given for single or transient episodes with asthma‐like symptoms .…”

Section: Introductionmentioning

confidence: 99%

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Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Mikalsen

Dalen

Karlstad

et al. 2019

Pediatric Pulmonology

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Diagnosing asthma and deciding treatment are difficult in young children. An inappropriate and too high prescription rate of inhaled corticosteroids (ICS) is suggested, but how airway symptoms are associated with prescriptions of asthma medication is less known. We studied how strongly wheeze, lower respiratory tract infections (LRTI), and atopic diseases are associated with dispensing of asthma medications during early childhood. We used data from the Norwegian Mother and Child Cohort Study and the Norwegian Prescription Database at four age‐intervals (0‐6, 6‐18, 18‐36 months, and 3‐7 years). Primary outcomes were dispensed asthma medications (no medication, short‐acting β‐2 agonist, or ICS). Relative risks (RRs) and average attributable fractions (AAFs) were estimated. Both wheeze and LRTI were positively associated with both medication groups (0‐6 months: no data on wheeze). The RRs and AAFs were higher for wheeze than LRTI. For ICS, the AAFs (95% CI) for wheeze vs LRTI were: 6 to 18 months: 69.2 (67.2, 71.2)% vs 10.4 (9.0, 11.8)%, 18 to 36 months: 33.0 (30.5, 35.5)% vs 10.0 (8.0, 12.0)%, and 3 to 7 years: 33.7 (31.0, 36.5)% vs 1.2 (0.5, 1.9)%. Except at 3 to 7 years of age, the AAFs were lower for atopic diseases than for LRTI and wheeze. Atopic diseases modified the associations between wheeze and ICS at 18 to 36 months and between LRTI or wheeze and ICS at 3 to 7 years. In conclusion, both wheeze and LRTI were associated with prescriptions of asthma medications in young children, with the strongest associations seen for wheeze. Atopic diseases contributed to these associations only in the oldest age groups.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Mikalsen

Dalen

Karlstad

et al. 2019

Pediatric Pulmonology

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“…Data from the Norwegian Prescription Database, NorPD, does not include diagnostic information, and we are therefore not able to discuss the indication for the antibiotic and antiasthmatic treatments prescribed. We know that most antibiotics and antiasthmatics are prescribed by GPs [ 18 , 19 ], but prescription habits may change over time and are influenced by several factors unaccounted for in this study. The dispensation of antibiotics in pregnancy shown in Table 1 , with 7%, 11%, and 13% in the respective trimesters, corresponds well with a previous study from Norway in the same time period using NorPD, showing 9.5%, 12%, and 12.6% of women receiving dispensed antibiotics in the three respective trimesters of pregnancy [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Relationship between Maternal and First Year of Life Dispensations of Antibiotics and Antiasthmatics

et al. 2018

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Antibiotics are the most frequent prescription drugs used by pregnant women. Our objective was to investigate if the dispensation of antibiotics and antiasthmatics in children less than 1 year of age is associated with prenatal antibiotic exposure. A secondary aim was to explore the incidence of dispensed antibiotics in pregnancy and dispensed antibiotics and antiasthmatics in children. We conducted an observational study using the Peer Academic Detailing study database to select patients eligible for match in the Medical Birth Registry of Norway, a total of 7747 mother-and-child pairs. Details on antibiotic and antiasthmatic pharmacy dispensations were obtained from the Norwegian Prescription Database. One quarter (1948 of 7747) of the mothers in the study had been dispensed antibiotics during pregnancy. In their first year of life, 17% (1289) of the children had had an antibiotic dispensation, 23% (1747) an antiasthmatic dispensation, and 8% (619) of the children had had both. We found a significant association between dispensed antibiotics in pregnancy and dispensed antibiotics to the child during their first year of life; OR = 1.16 (95% CI: 1.002–1.351). The association was stronger when the mothers were dispensed antibiotics at all, independent of the pregnancy period; OR = 1.60 (95% CI: 1.32–1.94). We conclude that the probability for dispensation of antibiotics was increased in children when mothers were dispensed antibiotics, independent of pregnancy. Diagnostic challenges in the very young and parental doctor-seeking behavior may, at least in part, contribute to the association between dispensations in mothers and children below the age of one year.

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“…The clinical model of NSILD demonstrated that the content of T-cells, T cytotoxic and T-helpers is inversely correlated with the level of free-radical oxidation products, which can be explained by the suppressive effect of this mechanism on the immune system, mainly, on the cellular link. Thus, the absolute amount of T cytotoxic correlates with the content of MDA, GP, SOD, while T-helpers -with the concentration of MDA, GP, and SOD (Mikalsen et al 2018). The authors suggested that free-radical oxidation products have a toxic effect on T-lymphocytes, inhibit their proliferation, cause membrane destruction via damage to the lipid layer, contribute to the formation of autoantigens and autoimmune reactions.…”

Section: Consistent Changes In Immunometabolic Parameters In Various mentioning

confidence: 99%

Immune-metabolic genesis of pathological processes

Земсков¹,

Berezhnova²,

Zemskova³

et al. 2019

RRP

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This article deals with metabolic-immune processes at rest and under stress conditions, which, in turn, results in the development of immune-dependent and immune-associated disorders. The article analyzes study results and conclusions of various literature sources and experimental data in healthy individuals and patients suffering from non-specific inflammatory lung diseases; purulent-inflammatory diseases and their combinations, primary and secondary progressive multiple sclerosis in the acute stage and remission. Research studies investigated the impact of the type, stage, combination of diseases on the parameters of the immunologic and metabolic statuses, as well as their correlations. The authors also analyzed metabolic effects of immunomodulators. Based on the analysis of the literature and own clinical and experimental data, the authors identified the ability of metabolic factors to regulate immunological processes. A correlative analysis of examination results of the patients with various diseases helped detect the unity of the immune-metabolic mechanisms of pathology. The data on the therapeutic effect of various modulators through differentiated biochemical chains and vice versa -the metabolic effect through immunological mechanisms -were analyzed in the study. Thus, one can testify that there is the phenomenon of a mediated effect of some immunocorrectors on the reactivity through metabolic chains. The fact that a number of modulators and metabolics can simultaneously affect the biochemical and immunological parameters of patients proved the above phenomenon. There was revealed a significant correlation interaction of the immune-metabolic parameters with various types of purulent-inflammatory diseases, which proves the formation of a single mechanism of pathology. Keywordsimmunomodulators, immunotropic effect, immuno-metabolic parameters, metabolics.Note: parameters of the standard formulas of the immune system disorders and metabolic disorders included in the key risk factors are given in bold; GP -glutathione reductase, GR -glutathione reductase, CIC -circulating immune complexes, VE -vitamin E, NK -natural killers, MDA -malonic dialdehyde, PPMS -primary progressive forms, SPMS -secondary progressive forms.

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Prescribing of asthma drugs for children 2004–2015

Cited by 5 publications

References 11 publications

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study

Relationship between Maternal and First Year of Life Dispensations of Antibiotics and Antiasthmatics

Immune-metabolic genesis of pathological processes

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