Journal Article

Analysis of Prescription Pattern and Guideline Adherence in the Management of Asthma Among Medical Institutions and Physician Specialties in Taiwan Between 2000 and 2010

Chou, Chia-Lin, Chen, Tzeng-Ji, Lin, Ting-Lun, Perng, Diahn-Warng, Lin, Anya Maan-Yuh, Chou, Yueh-Ching, Wu, Ming-Shan

2015

Overview

The aim of this study was to evaluate prescription patterns of antiasthmatic medications in ambulatory care, guideline adherence by physician specialties and medical institutions, and the rate of hospitalization and emergency department visits due to asthma exacerbation. The ambulatory visits between 2000 and 2010 from the Taiwan Longitudinal Health Insurance Database 2000 were analyzed for prescription trends. Seven classes of antiasthmatic medications were identified for prescription trend analysis. Prescription patterns of different medical institutions and physician specialties were further evaluated. We studied 4495 patients with newly diagnosed asthma in 2000. Estimates indicated an increased use in fixed-dose combination of inhaled corticosteroids and long-acting β2-agonists (3.6% in 2002 to 28.8% in 2010) with decreased use of inhaled corticosteroids (14.5% in 2001 to 7.3% in 2010). Xanthine was still the most frequently used medication for asthmatic patients (60.2% in 2001 and 45.2% in 2010). Another marked increase was the use of leukotriene receptor antagonists (2.6% in 2001 to 6.0% in 2010). In the studied population, the rate of hospital admission or emergency department visit moderately decreased from 1.42% to 0.59% during 10 years. Physicians in medical centers and regional hospitals, as well as asthma specialists, dominated the increased use of fixed-dose combinations of inhaled corticosteroids and long-acting β2-agonists and leukotriene receptor antagonists. Physicians in academic medical centers and asthma specialists achieved better adherence to the core recommendations of the international guidelines for asthma management. The reasons for guideline nonadherence among physicians in district hospitals and primary care clinics deserve health care professionals’ attention and require further investigation.

• Publisher: Elsevier Inc,Elsevier Limited
• Subject: Adrenal Cortex Hormones - therapeutic use / Adrenergic beta-2 Receptor Agonists - therapeutic use / Adult / Ambulatory Care / Anti-Asthmatic Agents - therapeutic use / Asthma / Asthma - drug therapy / Disease Management / Disease Progression / Drug Prescriptions / Drug Therapy, Combination - trends / Emergency Service, Hospital - utilization / Female / fixed-dose combination inhaler / Guideline Adherence / Health insurance / Hospitalization - statistics & numerical data / Humans / Internal Medicine / leukotriene receptor antagonist / long-acting β2-agonist / Male / Medical Education / Middle Aged / Physicians / Practice Patterns, Physicians / prescription patterns / Primary care / Studies / Taiwan / Xanthine - therapeutic use