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Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study

Natalie Divin Orcid Logo, Joanne Emma Given Orcid Logo, Joachim Tan, Gianni Astolfi, Elisa Ballardini, Laia Barrachina-Bonet, Clara Cavero-Carbonell Orcid Logo, Alessio Coi, Ester Garne Orcid Logo, Mika Gissler, Anna Heino, Sue Jordan Orcid Logo, Anna Pierini, Ieuan Scanlon, Stine Kjær Urhøj, Joan K Morris Orcid Logo, Maria Loane Orcid Logo

BMJ Open, Volume: 13, Issue: 10, Start page: e068885

Swansea University Authors: Sue Jordan Orcid Logo, Ieuan Scanlon

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DOI (Published version): 10.1136/bmjopen-2022-068885

Abstract

Objectives: To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies. Design: A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies we...

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Published in: BMJ Open
ISSN: 2044-6055 2044-6055
Published: BMJ 2023
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Design: A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort. Setting: Children born 2000–2014 in six regions within five European countries. Participants: 60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years. Primary outcome measure: Relative risks (RR) of &gt;1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03. Results: There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born &lt;32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30). Conclusion: This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions.</abstract><type>Journal Article</type><journal>BMJ Open</journal><volume>13</volume><journalNumber>10</journalNumber><paginationStart>e068885</paginationStart><paginationEnd/><publisher>BMJ</publisher><placeOfPublication/><isbnPrint/><isbnElectronic/><issnPrint>2044-6055</issnPrint><issnElectronic>2044-6055</issnElectronic><keywords>Antiasthmatic prescriptions, congenital anomalies, children, respiratory symptoms, EUROlinkCAT</keywords><publishedDay>31</publishedDay><publishedMonth>10</publishedMonth><publishedYear>2023</publishedYear><publishedDate>2023-10-31</publishedDate><doi>10.1136/bmjopen-2022-068885</doi><url>http://dx.doi.org/10.1136/bmjopen-2022-068885</url><notes/><college>COLLEGE NANME</college><department>Nursing</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HNU</DepartmentCode><institution>Swansea University</institution><apcterm>Another institution paid the OA fee</apcterm><funders>This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 733001.</funders><projectreference/><lastEdited>2024-04-10T15:24:51.2311301</lastEdited><Created>2023-10-16T12:31:32.1004163</Created><path><level id="1">Faculty of Medicine, Health and Life Sciences</level><level id="2">School of Health and Social Care - Nursing</level></path><authors><author><firstname>Natalie</firstname><surname>Divin</surname><orcid>0000-0002-6063-2451</orcid><order>1</order></author><author><firstname>Joanne Emma</firstname><surname>Given</surname><orcid>0000-0003-4921-1944</orcid><order>2</order></author><author><firstname>Joachim</firstname><surname>Tan</surname><order>3</order></author><author><firstname>Gianni</firstname><surname>Astolfi</surname><order>4</order></author><author><firstname>Elisa</firstname><surname>Ballardini</surname><order>5</order></author><author><firstname>Laia</firstname><surname>Barrachina-Bonet</surname><order>6</order></author><author><firstname>Clara</firstname><surname>Cavero-Carbonell</surname><orcid>0000-0002-4858-6456</orcid><order>7</order></author><author><firstname>Alessio</firstname><surname>Coi</surname><order>8</order></author><author><firstname>Ester</firstname><surname>Garne</surname><orcid>0000-0003-0430-2594</orcid><order>9</order></author><author><firstname>Mika</firstname><surname>Gissler</surname><order>10</order></author><author><firstname>Anna</firstname><surname>Heino</surname><order>11</order></author><author><firstname>Sue</firstname><surname>Jordan</surname><orcid>0000-0002-5691-2987</orcid><order>12</order></author><author><firstname>Anna</firstname><surname>Pierini</surname><order>13</order></author><author><firstname>Ieuan</firstname><surname>Scanlon</surname><order>14</order></author><author><firstname>Stine Kjær</firstname><surname>Urhøj</surname><order>15</order></author><author><firstname>Joan K</firstname><surname>Morris</surname><orcid>0000-0002-7164-612x</orcid><order>16</order></author><author><firstname>Maria</firstname><surname>Loane</surname><orcid>0000-0002-1206-3637</orcid><order>17</order></author></authors><documents><document><filename>64752__29019__c65aaec72bcb4d8b92325ba738ff3e8f.pdf</filename><originalFilename>64752.VOR.pdf</originalFilename><uploaded>2023-11-14T16:10:48.5604608</uploaded><type>Output</type><contentLength>924515</contentLength><contentType>application/pdf</contentType><version>Version of Record</version><cronfaStatus>true</cronfaStatus><documentNotes>© Author(s) (or their employer(s)) 2023. 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spelling v2 64752 2023-10-16 Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study 24ce9db29b4bde1af4e83b388aae0ea1 0000-0002-5691-2987 Sue Jordan Sue Jordan true false 9fcb224c6bd804a4d41a2a8570a71185 Ieuan Scanlon Ieuan Scanlon true false 2023-10-16 HNU Objectives: To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies. Design: A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort. Setting: Children born 2000–2014 in six regions within five European countries. Participants: 60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years. Primary outcome measure: Relative risks (RR) of >1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03. Results: There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born <32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30). Conclusion: This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions. Journal Article BMJ Open 13 10 e068885 BMJ 2044-6055 2044-6055 Antiasthmatic prescriptions, congenital anomalies, children, respiratory symptoms, EUROlinkCAT 31 10 2023 2023-10-31 10.1136/bmjopen-2022-068885 http://dx.doi.org/10.1136/bmjopen-2022-068885 COLLEGE NANME Nursing COLLEGE CODE HNU Swansea University Another institution paid the OA fee This work was supported by the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 733001. 2024-04-10T15:24:51.2311301 2023-10-16T12:31:32.1004163 Faculty of Medicine, Health and Life Sciences School of Health and Social Care - Nursing Natalie Divin 0000-0002-6063-2451 1 Joanne Emma Given 0000-0003-4921-1944 2 Joachim Tan 3 Gianni Astolfi 4 Elisa Ballardini 5 Laia Barrachina-Bonet 6 Clara Cavero-Carbonell 0000-0002-4858-6456 7 Alessio Coi 8 Ester Garne 0000-0003-0430-2594 9 Mika Gissler 10 Anna Heino 11 Sue Jordan 0000-0002-5691-2987 12 Anna Pierini 13 Ieuan Scanlon 14 Stine Kjær Urhøj 15 Joan K Morris 0000-0002-7164-612x 16 Maria Loane 0000-0002-1206-3637 17 64752__29019__c65aaec72bcb4d8b92325ba738ff3e8f.pdf 64752.VOR.pdf 2023-11-14T16:10:48.5604608 Output 924515 application/pdf Version of Record true © Author(s) (or their employer(s)) 2023. Distributed under the terms of a Creative Commons Attribution Non Commercial 4.0 License (CC BY-NC 4.0). true eng http://creativecommons.org/licenses/by-nc/4.0/
title Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
spellingShingle Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
Sue Jordan
Ieuan Scanlon
title_short Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
title_full Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
title_fullStr Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
title_full_unstemmed Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
title_sort Antiasthmatic prescriptions in children with and without congenital anomalies: a population-based study
author_id_str_mv 24ce9db29b4bde1af4e83b388aae0ea1
9fcb224c6bd804a4d41a2a8570a71185
author_id_fullname_str_mv 24ce9db29b4bde1af4e83b388aae0ea1_***_Sue Jordan
9fcb224c6bd804a4d41a2a8570a71185_***_Ieuan Scanlon
author Sue Jordan
Ieuan Scanlon
author2 Natalie Divin
Joanne Emma Given
Joachim Tan
Gianni Astolfi
Elisa Ballardini
Laia Barrachina-Bonet
Clara Cavero-Carbonell
Alessio Coi
Ester Garne
Mika Gissler
Anna Heino
Sue Jordan
Anna Pierini
Ieuan Scanlon
Stine Kjær Urhøj
Joan K Morris
Maria Loane
format Journal article
container_title BMJ Open
container_volume 13
container_issue 10
container_start_page e068885
publishDate 2023
institution Swansea University
issn 2044-6055
2044-6055
doi_str_mv 10.1136/bmjopen-2022-068885
publisher BMJ
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str School of Health and Social Care - Nursing{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}School of Health and Social Care - Nursing
url http://dx.doi.org/10.1136/bmjopen-2022-068885
document_store_str 1
active_str 0
description Objectives: To explore the risk of being prescribed/dispensed medications for respiratory symptoms and breathing difficulties in children with and without congenital anomalies. Design: A EUROlinkCAT population-based data linkage cohort study. Data on children with and without congenital anomalies were linked to prescription databases to identify children who did/did not receive antiasthmatic prescriptions. Data were analysed by age, European region, class of antiasthmatic, anomaly, sex, gestational age and birth cohort. Setting: Children born 2000–2014 in six regions within five European countries. Participants: 60 662 children with congenital anomalies and 1 722 912 reference children up to age 10 years. Primary outcome measure: Relative risks (RR) of >1 antiasthmatic prescription in a year, identified using Anatomical Therapeutic Chemical classification codes beginning with R03. Results: There were significant differences in the prescribing of antiasthmatics in the six regions. Children with congenital anomalies had a significantly higher risk of being prescribed antiasthmatics (RR 1.41, 95% CI 1.35 to 1.48) compared with reference children. The increased risk was consistent across all regions and all age groups. Children with congenital anomalies were more likely to be prescribed beta-2 agonists (RR 1.71, 95% CI 1.60 to 1.83) and inhaled corticosteroids (RR 1.74, 95% CI 1.61 to 1.87). Children with oesophageal atresia, genetic syndromes and chromosomal anomalies had over twice the risk of being prescribed antiasthmatics compared with reference children. Children with congenital anomalies born <32 weeks gestational age were over twice as likely to be prescribed antiasthmatics than those born at term (RR 2.20, 95% CI 2.10 to 2.30). Conclusion: This study documents the additional burden of respiratory symptoms and breathing difficulties for children with congenital anomalies, particularly those born preterm, compared with children without congenital anomalies in the first 10 years of life. These findings are beneficial to clinicians and healthcare providers as they identify children with greater morbidity associated with respiratory symptoms, as indicated by antiasthmatic prescriptions.
published_date 2023-10-31T15:24:47Z
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