ArticleBMJ open2013
General practitioners' prescribing behaviour as a determinant of poor persistence with inhaled corticosteroids in children with respiratory symptoms: mixed methods study.
Article in BMJ open, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed, 20 citations in OpenAlex.
- Serum proteomics identifies novel diagnostic biomarkers for asthma in preschool children.Journal of thoracic disease · 2024Article
- Question 3: Can we diagnose asthma in children under the age of 5 years?Paediatric respiratory reviews · 2019Review
- Primary care cohort study in the sequence of diagnosing chronic respiratory diseases and prescribing inhaled corticosteroids.NPJ primary care respiratory medicine · 2018Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo evaluate general practitioners' (GPs') prescribing behaviour as a determinant of persistence with and adherence to inhaled corticosteroids (ICS) in children.
designProspective observational study of persistence with and adherence to ICS followed by a focus group study of the GPs prescribing this treatment.
setting7 primary care practices in the area of Zwolle, the Netherlands.
participants134 children aged 2-12 years had been prescribed ICS in the year before the study started by their 19 GPs.
main outcome measuresPatterns and motives of GPs' prescribing behaviour and the relationship with persistence with and adherence to ICS.
resultsGPs' prescribing behaviour was characterised by prescribing short courses of ICS to children with various respiratory symptoms without follow-up for making a diagnosis of asthma. This was driven by the GPs' pragmatic approach to deal with the large number of children with respiratory symptoms, and by beliefs about ICS which differed from currently available evidence. This prescribing behaviour was the main reason why 68 (51%) children did not persist with the use of ICS. In children with persistent use of ICS and a GP's advice to use ICS on a daily basis, the median (IQR) adherence was 70% (41-84%), and was similar for patients with persistent asthma and children lacking a diagnosis or symptoms of asthma.
conclusionsInappropriate prescription of ICS to children by GPs is common and drives the lack of persistence with ICS therapy in primary care. This finding should be taken into account when interpreting data from large prescription database studies. Improving primary healthcare providers' knowledge and competence in diagnosing and managing asthma in children is needed.
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