Children and asthma medication : When is that inhaler just a breath away?

Abstract

The use of medicines in children has been receiving more attention during recent years. The aim of this thesis was to gain more insight in the process of medicines’ use in children by studying use of asthma medication. Evaluation of asthma medication use in children is challenging because of diagnostic difficulties in paediatric asthma and questions regarding effectiveness of medication. It thus requires a comprehensive approach taking into account the whole process of prescribing and treatment changes over time and family and prescriber influences as well as the age of the child. We found that the likelihood of receiving asthma medication is very high, especially in young children and is subject to physician and family influences. Uncertainties regarding diagnosis and treatment lead to use of trials of medication and may lead to more physician driven prescribing irrespective of the clinical context. Improvement of asthma medication therapy in children is warranted, but is highly dependent on better diagnostics and results from effectiveness studies. On the other hand the combined findings of our studies show that although many children receive asthma medication without an asthma diagnosis, use of these medicines is often a one-off event. We saw a clear difference in duration and intensity of treatment between children with and without asthma at a later age. Asthma medication use in children can be improved on many issues but is not as random as it may seem sometimes.