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From the Merck Sharp & Dohme, Paris (MB, VL, CC-V, LL); HESPER Claude Bernard University, Lyon (MB, LL, MG, EVG); Pediatric Pulmonology, AP-HP, Necker Enfants Malades Hospital, Paris; Paris Descartes University, Paris, France (JDB); Pediatric Medicine, Caen University Hospital, Caen (JB); Pediatric Noninvasive Ventilation and Sleep Unit, Necker University Hospital, Paris (BF); Paris Descartes University, Paris (BF); ESSEC Business School, Paris (GDP); and Respiratory Medicine, Croix Rousse University Hospital, Lyon, France (EVG).
Published: April 2016
AI Article Synopsis
Article Abstract
Recurrent wheezing (RW) has a significant impact on infants, caregivers, and society, but morbidity and related medical resource utilization (MRU) have not been thoroughly explored. The burden of RW needs to be documented with population-based data. The objective was to assess the characteristics, medical management, and MRU of RW infants identified from national claims data. Infants aged from 6 to 24 months, receiving ≥2 dispensations of respiratory drugs within 3 months, and presenting a marker of poor control (index date), were selected. During the 6 months after index date, MRU was described in the cohort and among 3 subgroups with more severe RW, defined as ≥4 dispensations of respiratory drugs, ≥3 dispensations of oral corticosteroids (OCS), or ≥1 hospitalization for respiratory symptoms. A total of 115,489 infants had RW, corresponding to 8.2% of subjects in this age group. During follow-up, 68.7% of infants received inhaled corticosteroids, but only 1.8 U (unit) were dispensed over 6 months, suggesting discontinuous use. Control was mostly inadequate: 61.7% of subjects received OCS, 80.2% antibiotics, and 71.2% short-acting beta-agonists, and medical/paramedical visits were numerous, particularly for physiotherapy. Severe RW concerned 39.0% of the cohort; 32.8% and 11.7% of infants had repeated use of respiratory drugs and OCS, respectively, and 5.5% were hospitalized for respiratory symptoms. In this real-life nation-wide study, RW was common and infants had poor control and high MRU. Interventions are needed to support adequate use of controller therapy, and to improve medical care.
