Variabilidad e idoneidad del tratamiento antiasmático en pediatría de atención primaria

Suárez-Castañón, C.; Modroño-Riaño, G.; Solı́s, Gonzalo

doi:10.1016/j.aprim.2016.07.001

Cited by 3 publications

(3 citation statements)

References 17 publications

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“…This fact has often been controversial in many countries like the United States (US) or the European Union (EU), due to the increasing need of moving forward faster in paediatric drug regulation from the perspective of clinical practice and real-world evidence. 6 Very few studies, such as Suarez-Castañ on et al, 7 have analysed the evidence of use for off-label medicines in primary health care setting. According to studies conducted in the EU member states, there is a large variation in off-label prevalence and no clear patterns were identified.…”

Section: Introductionmentioning

confidence: 99%

Off‐label drug use in neonates and infants in Spain: A five‐year observational study

Lizano-Díez

Kargodorian

Piñero-López

et al. 2021

Pharmacoepidemiology and Drug

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Objectives: To provide information about the off-label rate of all drug prescriptions in neonates and infants up to 1 year in Spain. Also, to analyse the off-label prescription of medicines under current practice in this age group according to different evidence sources.Study design: A five-year (2015-2019) exploratory observational study about off-label prescription in neonates and infants (0 to 1 year) at primary health care in Spain. All drug prescriptions in this age group were analysed and classified according to their labelling in off-label or on-label. The drugs prescribed off-label were subsequently reviewed in national formularies and other databases to assess its evidence of use beyond what is recommended in the Summary of Product Characteristics (SmPC).Results: On average 34.50% of total prescriptions were prescribed off-label according to the SmPC. 17.93% of total prescriptions in neonates and infants up to 1 year old were not based on clinical evidence from SmPC, Pediamécum, BNF or DailyMed. In more than 88% of cases, off-label use was related to the posology section of the SmPC, followed by the therapeutic indications and contraindications sections, in 35.20% and 24.10% of cases, respectively. Almost 13% of off-label drugs were over-the-counter. Salbutamol followed by topical tobramycin and colecalciferol were the drugs most prescribed off-label.Conclusions: Off-label use of drugs remains as an important public health concern, especially for neonates and infants up to 1 year, who receive the greatest proportion of offlabel prescriptions. The evidence-based off-label prescription is a widespread practice that has shown a stable trend during the 5-year study period providing also a certain extent of flexibility to paediatricians in some therapeutic decisions.

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Section: Introductionmentioning

confidence: 99%

Off‐label drug use in neonates and infants in Spain: A five‐year observational study

Lizano-Díez

Kargodorian

Piñero-López

et al. 2021

Pharmacoepidemiology and Drug

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“…The incidence of asthma occurs in all ages, especially in children [ 2 ]. Studies have shown that children under the age of 14 suffer the most severe damage from asthma [ 3 ]. With the acceleration of urbanization and the increase of air pollution, the prevalence of childhood asthma in China is increasing year by year, which poses a serious threat to children's physical and mental health [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Deep Learning Algorithms-Based CT Images in Glucocorticoid Therapy in Asthma Children with Small Airway Obstruction

Qin

Wang

Han

et al. 2021

Journal of Healthcare Engineering

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CT image information data under deep learning algorithms was adopted to evaluate small airway function and analyze the clinical efficacy of different glucocorticoid administration ways in asthmatic children with small airway obstruction. The Res-NET in the deep learning algorithm was used to perform feature extraction, summary classification, and other reconstruction of CT images. A deep learning network model Mask-R-CNN was constructed to enhance the ability of image reconstruction. A total of 118 children hospitalized with acute exacerbation of asthma in the hospital were recruited. After acute exacerbation treatment, 96 children with asthma were screened out for small airway obstruction, which were divided into glucocorticoid aerosol inhalation group (group A, 32 cases), glucocorticoid combined with bronchodilator aerosol inhalation group (group B, 32 cases), and oral hormone therapy group (group C, 32 cases). Asthmatic children with small airway obstruction were screened after acute exacerbation treatment and were rolled into glucocorticoid aerosol inhalation group (group A), glucocorticoid combined with bronchodilators aerosol inhalation group (group B), and oral hormone therapy group (group C). Lung function indicators (maximal mid-expiratory flow (MMEF75 and 25), 50% forced expiratory flow (FEF50), and 75% forced expiratory flow (FEF75)), FeNO level, and airway inflammation indicators (IL-6, IL-35, and eosinophilic (EOS)) were compared before and one month after treatment. The ratio of airway wall thickness to outer diameter (T/D) and the percentage of airway wall area to total airway area (WA%) were measured by e-Health high-resolution CT (HRCT). The constructed network model was used to measure the patient's coronary artery plaque and blood vessel volume, and the image was reconstructed on the Res-Net network. It was found that the MSE value of the Res-Net network was the lowest, and the efficiency was very high during the training process. T/D and WA (%) of asthmatic children with small airway obstruction after treatment were significantly lower than those before treatment ( P < 0.01 ). After treatment, MMEF75/25 and FEF75 were significantly higher than those before treatment ( P < 0.05 ). Lung function-related indicator FEF50 was significantly higher than that before treatment ( P < 0.01 ). FeNO level after treatment was remarkably lower than that before treatment ( P < 0.01 ). In addition, lung function-related indicators, airway inflammation indicators, and FeNO level improved the most in group C, followed by group B, and those improvements in group A were the least obvious, with great differences among groups ( P < 0.05 ). In summary, the Res-Net model proposed was of certain feasibility and effectiveness for CT image segmentation and can effectively improve the clinical evaluation of patient CT image information. Glucocorticoids could improve small airway function and airway inflammation in asthmatic children with small airway obstruction, and oral corticosteroids were more effective than aerosol inhalation therapy.

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“…Los autores concluyen que el uso de antiasmáticos en la población pediátrica es muy elevado, y no siempre cumple las guías de práctica clínica. Asimismo, informan de que existe gran variabilidad en las prescripciones entre diferentes zonas geográficas (189).…”

Section: Tratamientos Antiasmáticosunclassified

Evolución de las sibilancias en los primeros diez años de vide en la provincia de Salamanca. Factores de riesgo asociados

Cabrera¹,

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Variabilidad e idoneidad del tratamiento antiasmático en pediatría de atención primaria

Abstract: 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.

Cited by 3 publications

References 17 publications

Off‐label drug use in neonates and infants in Spain: A five‐year observational study

Off‐label drug use in neonates and infants in Spain: A five‐year observational study

Deep Learning Algorithms-Based CT Images in Glucocorticoid Therapy in Asthma Children with Small Airway Obstruction

Evolución de las sibilancias en los primeros diez años de vide en la provincia de Salamanca. Factores de riesgo asociados

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