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Prevalence of inappropriate prescribing of inhaled corticosteroids for respiratory tract infections in the Netherlands: a retrospective cohort study.

Teichert M, Schermer T, van den Nieuwenhof L, De Smet PA, Wensing M - NPJ Prim Care Respir Med (2014)

Bottom Line: These ICS were mainly prescribed by general practitioners, mostly during winter months, for elderly persons, after high dosages of oral corticosteroids, and in single-inhaler combinations with a long-acting β2-agonist.The extrapolated total annual expense for this ICS use was € 555,000.In the Netherlands one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions was considerably lower than in Australia.

View Article: PubMed Central - PubMed

Affiliation: 1] Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboudumc, Nijmegen, The Netherlands [2] Royal Dutch Pharmacists Association (KNMP), The Hague, The Netherlands.

ABSTRACT

Background: Inhaled corticosteroids (ICS) are recommended in prevailing guidelines for use in patients with persistent asthma or moderate-to-severe chronic obstructive pulmonary disease (COPD) and recurrent exacerbations. Recent data from Australia showed that 44% of patients with a single ICS dispensing and without other respiratory inhalation medications ('one-off ICS') were co-dispensed oral antibiotics. Evidence of the merit of ICS for treating respiratory infections in subjects without asthma or COPD is lacking.

Aims: The aims of the study were to describe the rate of one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions in the Netherlands, and to compare this with the rate of one-off ICS dispensing in combination with oral antibiotics as reported earlier from Australia.

Methods: Dispensing data were obtained from the Dutch Foundation of Pharmaceutical Statistics. Additional information was available on patients' age, sex and prescriber. Patients with any ICS dispensing in 2011 were selected.

Results: Data were available from 1,725 Dutch community pharmacies (88%). Of 845,068 ICS users in 2011, 10% were dispensed one-off ICS, among which 13% had oral antibiotics co-dispensed. These ICS were mainly prescribed by general practitioners, mostly during winter months, for elderly persons, after high dosages of oral corticosteroids, and in single-inhaler combinations with a long-acting β2-agonist. The extrapolated total annual expense for this ICS use was € 555,000.

Conclusion: In the Netherlands one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions was considerably lower than in Australia.

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Related in: MedlinePlus

Time lag of co-dispensing of one-off inhaled corticosteroids (ICS) and oral antibiotics in 2011 (based on data from 1,725 (89%) Dutch community pharmacies).
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fig3: Time lag of co-dispensing of one-off inhaled corticosteroids (ICS) and oral antibiotics in 2011 (based on data from 1,725 (89%) Dutch community pharmacies).

Mentions: Concomitant use of one-off ICS and oral antibiotics occurred throughout the year in all age categories (Figures 2a and b). All patterns showed a slight increase in one-off ICS dispensing with oral antibiotics during the winter months, that was most pronounced for the age category of 80 years and older that also used antiallergics (Figure 2b). Overall, 67% of co-dispensing of one-off ICS and antibiotics occurred on the same day (Figure 3). The remaining antibiotic co-dispensing was distributed as 23% during the week after the ICS dispensing and 10% during the week before. The majority (69.7%) of one-off ICS dispensings with oral antibiotics were a combination of ICS and LABA (Table 2).


Prevalence of inappropriate prescribing of inhaled corticosteroids for respiratory tract infections in the Netherlands: a retrospective cohort study.

Teichert M, Schermer T, van den Nieuwenhof L, De Smet PA, Wensing M - NPJ Prim Care Respir Med (2014)

Time lag of co-dispensing of one-off inhaled corticosteroids (ICS) and oral antibiotics in 2011 (based on data from 1,725 (89%) Dutch community pharmacies).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373501&req=5

fig3: Time lag of co-dispensing of one-off inhaled corticosteroids (ICS) and oral antibiotics in 2011 (based on data from 1,725 (89%) Dutch community pharmacies).
Mentions: Concomitant use of one-off ICS and oral antibiotics occurred throughout the year in all age categories (Figures 2a and b). All patterns showed a slight increase in one-off ICS dispensing with oral antibiotics during the winter months, that was most pronounced for the age category of 80 years and older that also used antiallergics (Figure 2b). Overall, 67% of co-dispensing of one-off ICS and antibiotics occurred on the same day (Figure 3). The remaining antibiotic co-dispensing was distributed as 23% during the week after the ICS dispensing and 10% during the week before. The majority (69.7%) of one-off ICS dispensings with oral antibiotics were a combination of ICS and LABA (Table 2).

Bottom Line: These ICS were mainly prescribed by general practitioners, mostly during winter months, for elderly persons, after high dosages of oral corticosteroids, and in single-inhaler combinations with a long-acting β2-agonist.The extrapolated total annual expense for this ICS use was € 555,000.In the Netherlands one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions was considerably lower than in Australia.

View Article: PubMed Central - PubMed

Affiliation: 1] Scientific Institute for Quality of Healthcare (IQ Healthcare), Radboudumc, Nijmegen, The Netherlands [2] Royal Dutch Pharmacists Association (KNMP), The Hague, The Netherlands.

ABSTRACT

Background: Inhaled corticosteroids (ICS) are recommended in prevailing guidelines for use in patients with persistent asthma or moderate-to-severe chronic obstructive pulmonary disease (COPD) and recurrent exacerbations. Recent data from Australia showed that 44% of patients with a single ICS dispensing and without other respiratory inhalation medications ('one-off ICS') were co-dispensed oral antibiotics. Evidence of the merit of ICS for treating respiratory infections in subjects without asthma or COPD is lacking.

Aims: The aims of the study were to describe the rate of one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions in the Netherlands, and to compare this with the rate of one-off ICS dispensing in combination with oral antibiotics as reported earlier from Australia.

Methods: Dispensing data were obtained from the Dutch Foundation of Pharmaceutical Statistics. Additional information was available on patients' age, sex and prescriber. Patients with any ICS dispensing in 2011 were selected.

Results: Data were available from 1,725 Dutch community pharmacies (88%). Of 845,068 ICS users in 2011, 10% were dispensed one-off ICS, among which 13% had oral antibiotics co-dispensed. These ICS were mainly prescribed by general practitioners, mostly during winter months, for elderly persons, after high dosages of oral corticosteroids, and in single-inhaler combinations with a long-acting β2-agonist. The extrapolated total annual expense for this ICS use was € 555,000.

Conclusion: In the Netherlands one-off ICS dispensing in combination with oral antibiotics in subjects without chronic respiratory conditions was considerably lower than in Australia.

Show MeSH
Related in: MedlinePlus