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The treatment of paediatric asthma in the private health care sector of South Africa : a retrospective drug utilisation review / J. Mouton

Asthma is the most common chronic disease among children worldwide. The prescribing
patterns of the medication used to treat asthma in South Africa, as well as the prevalence of
paediatric asthma are of interest and need to be investigated.
A drug utilisation review was performed to determine the prevalence of asthma, and in
particular paediatric asthma in a section of the private health care sector of South Africa. The
prescribing patterns of asthma medication were investigated according to different
demographic factors, such as gender, geographical area and prescriber type. Data from a
medical claims database were extracted and processed to reveal the different prescribing
patterns from 1 January 2005 to 31 December 2008. Medication from the MIMS®
pharmacological groups 10.2 and 10.4 were used as a basis for asthma medication. Patients
had to use at least one medicine item from one of these groups to be included in the study.
The prevalence of asthma in the general population showed an increase from 2005 to 2008.
The prevalence of asthma as a part of the total database according to the number of patients
increased from 23.01% in 2005 (n=347342) to 24.72% in 2008 (n=240854), although the
number of patients on the total database decreased from 2005 to 2008. When investigating
the number of prescriptions that were dispensed during 2008, asthma prescriptions
comprised 7.16% (n=484983) of all prescriptions and the number of asthma medicine items
that were dispensed made up 3.72% (n=611139) of the total number of medicine items
dispensed in 2008.
Paediatric asthma was divided into two age groups for the purpose of this study namely, 0 -
4 years of age and older than 4 years, but younger or equal to 11 years of age ( >4 - 11
years), according to a previous study done by the National Heart Lung and Blood Institute
(NHLBI). The results from the data confirmed that the prevalence of asthma was higher in
the younger age group. The number of patients using asthma medication in the 0 - 4 years
age group comprised 44.40% (n=11306) of the total number of patients in this age group on
the database in 2008, compared to 32.84% (n=28347) in the >4 - 11 years age group.
Asthma was more common among male patients, whether they were included in the
paediatric groups or not. The geographical distribution of paediatric asthma seemed to be
connected to the provinces without coastlines and different mining facilities. The combination of asthma medication with antibiotics and systemic corticosteroids were investigated and it
was concluded that antibiotics that were used for respiratory tract infections were prescribed
the most frequently to asthma patients.
The refill–adherence rates of patients with asthma were not satisfactory when considering
that asthma is a chronic disease. The average adherence rate for all the asthma products
that were brought into account when calculating the refill–adherence rate was 60.95%. A rate
above 90% indicates optimal patient adherence.
In conclusion this study determined that asthma has a significant prevalence among children
in South Africa. The prescribing patterns for the different medication used in the treatment of
asthma were investigated and recommendations for further research in this field of study
were made. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2011.

Identiferoai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:nwu/oai:dspace.nwu.ac.za:10394/4648
Date January 2010
CreatorsMouton, Jeanine
PublisherNorth-West University
Source SetsSouth African National ETD Portal
Detected LanguageEnglish
TypeThesis

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