Sammanfattning
BACKGROUND: Asthma in children may be difficult to diagnose. There are few objective diagnostic tests available for pre-school children, and the guidelines for diagnosis and treatment are based on history and clinical examination. This may cause variation in treatment practice.
MATERIAL AND METHOD: Data from the Norwegian Prescription Database were used to study the prescribing of asthma drugs for children in the age groups 0–4 years and 5–9 years by county from 2004–15.
RESULTS: The proportion per 1000 children who were prescribed asthma drugs for the period 2012–14 varied considerably between counties (0–4 years: median: 104/1 000: range: 64–147; 5–9 years: 68/1 000, 46–86). Inhaled steroids were most frequently prescribed and varied most between the counties in both of the age groups (0–4 years: 85/1 000; 42–116, 5–9 years: 51/1 000; 31–70). Most patients received only one or few prescriptions for inhaled steroids over a three-year period. The change in the prescribing of inhaled steroids from 2004–15 varied significantly between the counties, most for the age group 0–4 years.
INTERPRETATION: The significant difference in prescribing rates of asthma drugs between counties, high proportion of sporadic use and change over time, particularly in the youngest age group, may indicate a variation in treatment that cannot be explained by differences in the prevalence of asthma. One cause may be unclear guidelines that are insufficiently implemented in clinical practice.