Paediatric prescribing of asthma drugs in the UK:: are we sticking to the guideline?

Background: Asthma guidelines should lead to improved, more rational asthma medication prescribing. The aims of this study were to assess trends in paediatric asthma drug prescribing in the UK and to assess the potential impact of the publication of the British Thoracic Society (BTS) asthma guideline. Methods: The estimated community paediatric prescribing figures for asthma medications in the UK were studied using data from the NHS Information Centre for Health and Social Care for the years 2000-2006. Results: The numbers of prescriptions for bronchodilator syrups decreased by 60% from 2000 to 2006. However, this still represents 121 000 prescriptions for bronchodilator syrups in 2006 despite minimal recommendations for their use. The percentage of steroid inhalers prescribed as combination inhalers of a steroid and a long-acting beta agonist increased from 2.6% in 2000 to 20.6% in 2006. Conclusions: Steroid-alone inhalers should be the mainstay for the vast majority of patients with asthma who require controller medications. The increase in the number of combination inhalers prescribed is not consistent with the guideline recommendations that combination inhalers should only be introduced in those patients with asthma not controlled on adequate doses of inhaled steroids. Further education of health professionals is required.