Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study
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...
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Veröffentlicht in: | Pediatric pulmonology 2019-10, Vol.54 (10), p.1557-1566 |
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description | 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. |
doi_str_mv | 10.1002/ppul.24437 |
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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.</description><identifier>ISSN: 8755-6863</identifier><identifier>EISSN: 1099-0496</identifier><identifier>DOI: 10.1002/ppul.24437</identifier><identifier>PMID: 31273956</identifier><language>eng</language><publisher>United States</publisher><subject>Adrenal Cortex Hormones - therapeutic use ; airway symptoms ; allergy ; Anti-Asthmatic Agents - therapeutic use ; Asthma - drug therapy ; Asthma - epidemiology ; asthma and early wheeze ; asthma medication ; atopy ; Child ; Child, Preschool ; children ; Cohort Studies ; Female ; Humans ; Hypersensitivity, Immediate - epidemiology ; Infant ; Infant, Newborn ; Male ; pharmacology ; prescription ; Respiratory Sounds ; Respiratory Tract Infections - epidemiology ; the Norwegian Mother and Child Cohort Study (MoBa)</subject><ispartof>Pediatric pulmonology, 2019-10, Vol.54 (10), p.1557-1566</ispartof><rights>2019 Wiley Periodicals, Inc.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3657-b345b10af2b66230ea04757b29520a3841139096ff780ea940b98b6e1c53f8d83</citedby><cites>FETCH-LOGICAL-c3657-b345b10af2b66230ea04757b29520a3841139096ff780ea940b98b6e1c53f8d83</cites><orcidid>0000-0003-4192-8342</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fppul.24437$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fppul.24437$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31273956$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mikalsen, Ingvild Bruun</creatorcontrib><creatorcontrib>Dalen, Ingvild</creatorcontrib><creatorcontrib>Karlstad, Øystein</creatorcontrib><creatorcontrib>Eide, Geir Egil</creatorcontrib><creatorcontrib>Magnus, Maria</creatorcontrib><creatorcontrib>Nystad, Wenche</creatorcontrib><creatorcontrib>Øymar, Knut</creatorcontrib><title>Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study</title><title>Pediatric pulmonology</title><addtitle>Pediatr Pulmonol</addtitle><description>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.</description><subject>Adrenal Cortex Hormones - therapeutic use</subject><subject>airway symptoms</subject><subject>allergy</subject><subject>Anti-Asthmatic Agents - therapeutic use</subject><subject>Asthma - drug therapy</subject><subject>Asthma - epidemiology</subject><subject>asthma and early wheeze</subject><subject>asthma medication</subject><subject>atopy</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>children</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Hypersensitivity, Immediate - epidemiology</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>pharmacology</subject><subject>prescription</subject><subject>Respiratory Sounds</subject><subject>Respiratory Tract Infections - epidemiology</subject><subject>the Norwegian Mother and Child Cohort Study (MoBa)</subject><issn>8755-6863</issn><issn>1099-0496</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>WIN</sourceid><sourceid>EIF</sourceid><recordid>eNp9kLtOwzAYRi0EoqWw8ADII0JK8SV2Yraq4iZVogOdI8dxWiMnDnaiKhuPwDPyJKS0MDL9w3d0pP8AcInRFCNEbpums1MSxzQ5AmOMhIhQLPgxGKcJYxFPOR2BsxDeEBo2gU_BiGKSUMH4GKxnxm9lD0NfNa2rApR1AWXrmh6aGvauq9dQbYwtvK5h43VQ3uR6QEK7qSSsdGGUbI2rwx2cQSv9Wn99fAYlrYbKbZxvYWi7oj8HJ6W0QV8c7gSsHu5f50_R4uXxeT5bRIpylkQ5jVmOkSxJzjmhSEsUJyzJiWAESZrGGFOBBC_LJB1GEaNcpDnXWDFapkVKJ-B67228e-90aLPKBKWtlbV2XcgIYZSkeNAN6M0eVd6F4HWZNd5U0vcZRtkubLYLm_2EHeCrg7fLh6f_0N-SA4D3wNZY3f-jypbL1WIv_QZO5ITc</recordid><startdate>201910</startdate><enddate>201910</enddate><creator>Mikalsen, Ingvild Bruun</creator><creator>Dalen, Ingvild</creator><creator>Karlstad, Øystein</creator><creator>Eide, Geir Egil</creator><creator>Magnus, Maria</creator><creator>Nystad, Wenche</creator><creator>Øymar, Knut</creator><scope>24P</scope><scope>WIN</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4192-8342</orcidid></search><sort><creationdate>201910</creationdate><title>Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study</title><author>Mikalsen, Ingvild Bruun ; Dalen, Ingvild ; Karlstad, Øystein ; Eide, Geir Egil ; Magnus, Maria ; Nystad, Wenche ; Øymar, Knut</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3657-b345b10af2b66230ea04757b29520a3841139096ff780ea940b98b6e1c53f8d83</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adrenal Cortex Hormones - therapeutic use</topic><topic>airway symptoms</topic><topic>allergy</topic><topic>Anti-Asthmatic Agents - therapeutic use</topic><topic>Asthma - drug therapy</topic><topic>Asthma - epidemiology</topic><topic>asthma and early wheeze</topic><topic>asthma medication</topic><topic>atopy</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>children</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Hypersensitivity, Immediate - epidemiology</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>pharmacology</topic><topic>prescription</topic><topic>Respiratory Sounds</topic><topic>Respiratory Tract Infections - epidemiology</topic><topic>the Norwegian Mother and Child Cohort Study (MoBa)</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mikalsen, Ingvild Bruun</creatorcontrib><creatorcontrib>Dalen, Ingvild</creatorcontrib><creatorcontrib>Karlstad, Øystein</creatorcontrib><creatorcontrib>Eide, Geir Egil</creatorcontrib><creatorcontrib>Magnus, Maria</creatorcontrib><creatorcontrib>Nystad, Wenche</creatorcontrib><creatorcontrib>Øymar, Knut</creatorcontrib><collection>Wiley Online Library (Open Access Collection)</collection><collection>Wiley Online Library Free Content</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric pulmonology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mikalsen, Ingvild Bruun</au><au>Dalen, Ingvild</au><au>Karlstad, Øystein</au><au>Eide, Geir Egil</au><au>Magnus, Maria</au><au>Nystad, Wenche</au><au>Øymar, Knut</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study</atitle><jtitle>Pediatric pulmonology</jtitle><addtitle>Pediatr Pulmonol</addtitle><date>2019-10</date><risdate>2019</risdate><volume>54</volume><issue>10</issue><spage>1557</spage><epage>1566</epage><pages>1557-1566</pages><issn>8755-6863</issn><eissn>1099-0496</eissn><abstract>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.</abstract><cop>United States</cop><pmid>31273956</pmid><doi>10.1002/ppul.24437</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0003-4192-8342</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Adrenal Cortex Hormones - therapeutic use airway symptoms allergy Anti-Asthmatic Agents - therapeutic use Asthma - drug therapy Asthma - epidemiology asthma and early wheeze asthma medication atopy Child Child, Preschool children Cohort Studies Female Humans Hypersensitivity, Immediate - epidemiology Infant Infant, Newborn Male pharmacology prescription Respiratory Sounds Respiratory Tract Infections - epidemiology the Norwegian Mother and Child Cohort Study (MoBa) |
title | Airway symptoms and atopy in young children prescribed asthma medications: A large‐scale cohort study |
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