Pols David H J, Nielen Mark M J, Bohnen Arthur M, Korevaar Joke C, Bindels Patrick J E
Department of General Practice, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
NIVEL, Netherlands Institute for Health Services Research, Utrecht, The Netherlands.
PLoS One. 2017 Aug 24;12(8):e0182664. doi: 10.1371/journal.pone.0182664. eCollection 2017.
A comprehensive and representative nationwide general practice database was explored to study associations between atopic disorders and prescribed medication in children.
All children aged 0-18 years listed in the NIVEL Primary Care Database in 2014 were selected. Atopic children with atopic eczema, asthma and allergic rhinitis (AR) were matched with controls (not diagnosed with any of these disorders) within the same general practice on age and gender. Logistic regression analyses were performed to study the differences in prescribed medication between both groups by calculating odds ratios (OR); 93 different medication groups were studied.
A total of 45,964 children with at least one atopic disorder were identified and matched with controls. Disorder-specific prescriptions seem to reflect evidence-based medicine guidelines for atopic eczema, asthma and AR. However, these disorder-specific prescriptions were also prescribed for children who were not registered as having that specific disorder. For eczema-related medication, about 3.7-8.4% of the children with non-eczematous atopic morbidity received these prescriptions, compared to 1.4-3.5% of the non-atopic children. The same pattern was observed for anti-asthmatics (having non-asthmatic atopic morbidity: 0.8-6.2% vs. controls: 0.3-2.1%) and AR-related medication (having non-AR atopic morbidity: 4.7-12.5% vs. controls: 2.8-3.1%). Also, non-atopic related medication, such as laxatives and antibiotics were more frequently prescribed for atopic children.
The present study shows that atopic children received more prescriptions, compared to non-atopic children. Non-atopic controls frequently received specific prescriptions for atopic disorders. This indicates that children with atopic disorders need better monitoring by their GP.
探索一个全面且具有代表性的全国性全科医疗数据库，以研究儿童特应性疾病与处方药物之间的关联。
选取2014年NIVEL初级医疗数据库中列出的所有0至18岁儿童。患有特应性皮炎、哮喘和过敏性鼻炎（AR）的特应性儿童在同一家全科医疗机构内按年龄和性别与对照组（未被诊断患有这些疾病中的任何一种）进行匹配。通过计算比值比（OR）进行逻辑回归分析，以研究两组之间处方药物的差异；研究了93个不同的药物组。
共识别出45964名患有至少一种特应性疾病的儿童，并与对照组进行了匹配。特定疾病的处方似乎反映了针对特应性皮炎、哮喘和AR的循证医学指南。然而，这些特定疾病的处方也开给了未登记患有该特定疾病的儿童。对于与湿疹相关的药物，患有非湿疹性特应性疾病的儿童中约3.7 - 8.4%接受了这些处方，而非特应性儿童为1.4 - 3.5%。抗哮喘药物（患有非哮喘性特应性疾病：0.8 - 6.2%，对照组：0.3 - 2.1%）和与AR相关的药物（患有非AR特应性疾病：4.7 - 12.5%，对照组：2.8 - 3.1%）也观察到相同模式。此外，特应性儿童更频繁地开具非特应性相关药物，如泻药和抗生素。
本研究表明，与非特应性儿童相比，特应性儿童接受的处方更多。非特应性对照组经常接受针对特应性疾病的特定处方。这表明患有特应性疾病的儿童需要其全科医生进行更好的监测。
