July 2024
Temporal trends in the prevalence of preventer medication prescription by general practice registrars for paediatric asthma: A longitudinal analysis
Nina Reid,1 Katie Fisher,1,2 Anna Ralston,1,2 Amanda Tapley,1,2 Elizabeth Holliday,1 Ian Charlton,1 Katherine Chen,3–5 Jason Dizon,6 Dominica Moad,1,2 Alison Fielding,1,2 Andrew Davey,1,2 Mieke Van Driel,7 Lisa Clarke,8 Parker Magin1,2,9
1The University of Newcastle, School of Medicine and Public Health, Newcastle, NSW
2The Royal Australian College of General Practitioners, General Practice Training Research Department, Newcastle, NSW
3Health Services Group, Murdoch Children’s Research Institute, The Royal Children’s Hospital, Melbourne, Vic
4Department of General Medicine, The Royal Children’s Hospital, Melbourne, Vic
5Department of Paediatrics, The University of Melbourne, Melbourne, Vic
6Clinical Research Design IT and Statistical Support Unit (CReDITSS), Hunter Medical Research Institute, Newcastle, NSW
7The University of Queensland, Faculty of Medicine, General Practice Clinical Unit, Royal Brisbane and Women’s Hospital, Brisbane, Qld
8GP Training Medical Education Department, The Royal Australian College of General Practitioners, Hobart, Tas
9School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, NSW
Background and objectives
Underprescription of preventer medications and over-reliance on short-acting beta agonist medications have been shown to increase paediatric asthma exacerbations, hospitalisations and deaths. This study aimed to investigate temporal trends in the prescribing of preventer medications for paediatric asthma, by Australian general practice registrars.
Methods
Longitudinal analyses of 2010–22 data from the Registrars Clinical Encounters in Training (ReCEnT) study were undertaken. Proportions of paediatric asthma presentations where preventer medication was prescribed were calculated, and temporal trends were analysed using mixed-effects logistic regression.
Results
There was no temporal change in registrar prescribing of paediatric asthma preventer medications, although changes were seen in preventer medications types prescribed (decreased combination inhalers; increased inhaled corticosteroids).
Discussion
No increased overall prescriptions of asthma preventers, despite guideline recommendations and extensive educational efforts, raise concerns regarding the effectiveness of ‘preventer importance’ messaging/dissemination. Thus, the results have significant implications for clinical practice, medical education and policy.