Prescription Patterns of Anti-asthmatic Medications and Asthma Control

• Main Authors: Ting-Lun Lin, 林廷倫
• Other Authors: Yueh-Ching Chou
• Format: Others
• Language: zh-TW
• Published: 2012
• Online Access: http://ndltd.ncl.edu.tw/handle/49879909875806308261

碩士 === 國立陽明大學 === 藥理學研究所 === 100 === Background: Asthma has emerged as an important health problem in Taiwan due to the increase in its prevalence in recent years. With the updated asthma guidelines were published and new asthma medications launched, the mainstream medications used for asthma treatment have changed to inhaled drugs, providing more effective asthma control. However, a long-term population-based study focusing on the trends of anti-asthmatic medications use in Taiwan is lacking. The aim of this study is to investigate the change in trends of anti-asthmatic drugs use and relationship between the drug utilization change and asthma control among Taiwanese patients. We further evaluate whether this this change in drug utilization meet guideline recommendations. Method: We conducted a longitudinal study from 2000 to 2010 using the one million randomly sample cohort database from the National Health Insurance (NHI) Database to analyze prescriptions for patients aged over 18 years old with a new diagnosis of asthma in 2000. Result: A total of 1639 patients with newly diagnosed asthma in 2000. The proportions of inhaled anti-asthmatic prescriptions were increased yearly from 19.8% to 47.1%, whereas oral anti-asthmatic prescriptions decreased from 91.2% to 75.4%. Regarding to the utilization of each class of medication, the proportion of FDC use significantly increased yearly from 3.6% to 28.5%, and it became the most commonly used inhalers after 2006. The utilization rate of leukotriene receptor antagonists (LTA) increased from 0.7% to 6.2%. Xanthine derivatives was the most frequently prescribed drug, with the utilization rate of 53.9% in 2000 increasing to 65.6% in 2005, followed by a decrease to 44.2% in 2010. Compared with district hospital and clinics, higher prescription rates in inhaled anti-asthmatic medications than in oral agents was noted in medical centers and regional hospitals. The prescription rates of FDC increased mostly in medical centers. With respect to physician specialties, only asthma specialists’ practice showed higher prescription rates in anti-asthmatic medications than in oral agents. The prescription rates of FDC increased mostly in asthma specialists from 13.1% increasing to 58.9%. Over the study period, the incidence of emergency visits for asthma exacerbations in studied population was decreased from 2.93% to 1.34% (p<0.05). Conclusion: The utilization of anti-asthmatic drugs in Taiwan illustrated a gradually decline trend in oral agents use and upward trend in inhalers use. Among inhaled medications, the use of FDC showed the greatest increase. Those observations are in accord with the recommendation of GINA. Another finding of the decline in incidence of emergency visits for asthma exacerbation may indirectly prove that the changes in trends of medication use contribute to better asthma control. However, the definite correlation between the changed prescription patterns and asthma control need further investigation.