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U.K. Doctors Deviating from Asthma Guidelines

Records indicate excessive use of oral beta-agonists and steroid/long-acting beta-agonist inhalers in children

FRIDAY, Sept. 7 (HealthDay News) -- Prescription records suggest that physicians in the United Kingdom are overprescribing oral beta-agonists and inhaled combinations of long-acting beta-agonists and steroids in children with asthma, according to research published online Sept. 4 in the Archives of Disease in Childhood.

Simon Cohen, of the Sydney Children's Hospital in Randwick, Australia, and colleagues analyzed data from the National Health Service Information Centre for Health and Social Care for the years 2000 to 2006.

The investigators found that prescriptions for bronchodilator syrups -- which are of "very little use" in childhood asthma management -- decreased by 60 percent during this time period, although 121,000 prescriptions were still written in 2006. In addition, during this time period the percentage of inhaled steroids prescribed in combination with a long-acting beta-agonist increased from 2.6 percent to 20.6 percent, which is not consistent with the British Thoracic Society (BTS) guideline recommendations. The guideline states that combination inhalers should only be used by patients whose asthma is not controlled with adequate doses of inhaled steroids, the report indicates.

"A challenge faced by many of those issuing guidelines is to obtain high levels of use in the community," the authors write. "It is difficult to comment on the direct impact of the BTS guideline. However, our data suggest that prescribing in the community deviates from the guideline."

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