Anti-asthma medication prescribing to children in the Lombardy Region of Italy: chronic versus new users

The analysis involved prescriptions given to 6-17 year olds between 2003 and 2005 in Italy's Lombardy Region. The youths were classified as potential asthmatics, based on the different degree of drug utilization: occasional, low or high users, and grouped as 'new onset' or 'chronic' cases based on the duration of therapy dispensed. The analysis of prescriptions and hospitalization rate of these groups provided an estimate of the 2005 asthma prevalence and incidence and allowed an estimation of the level of appropriateness of treatments.During 2005, the estimated incidence of potential asthmatics was 0.8% and the estimated prevalence was 3.5%. When viewed retrospectively for two years, records showed that 47% of potential asthmatics received prescriptions also during 2004 and 30% also during 2003. During the three years considered, 7.5%, 2.8%, and 1.5% of high, low, and occasional users, respectively, were hospitalized for asthma. The most important inappropriateness found was the prescription of long acting beta adrenergics as first time treatment.This study allowed a proxy of asthma incidence, prevalence, and severity. The analyses highlighted a low compliance with the guidelines, suggesting that educational interventions are needed to obtain a more rational management of childhood asthma, especially in subjects starting therapy.Asthma is one of the leading chronic childhood diseases, and its prevalence in Italy remained largely stable between 1995 and 2002 (9%) [1]. Prior to school age many children experience recurrent episodes of wheezing and cough. These symptoms are frequently transient, and 60% of preschoolers are asymptomatic by age six [2,3]. For this reason, children have a higher overall prevalence of anti-asthmatic prescriptions compared to adolescents. Regarding asthma therapy, international guidelines recommend inhaled corticosteroids (ICS) for long-term control of persistent asthma and short acting β2 adrenergic (SABA), such as salbutamol, as first ch