Drug Prescribing Patterns for the Treatment of Asthma and Chronic Obstructive Pulmonary Disease in Korea

우리나라에서의 천식 및 만성폐쇄성폐질환 치료제 처방 양상

  • Jang, Jin Kyung (Department of Pharmacy, St. Mary's Hospital, The Catholic University of Korea) ;
  • Kim, Hae Sook (Department of Pharmacy, Gangneung Asan Hospital) ;
  • Sohn, Hyun Soon (College of Pharmacy, Sookmyung Women's University) ;
  • Park, Chanmi (Review and Assessment Research Institute, Health Insurance Review and Assessment Services) ;
  • Kim, Ju Sang (Department of Internal Medicine, St. Mary's Hospital, The Catholic University of Korea) ;
  • Jung, Bock Hyun (Department of Internal Medicine, Gangneung Asan Hospital) ;
  • Ji, Eunhee (College of Pharmacy, Gachon University) ;
  • Cho, Jung Hwan (College of Pharmacy, Sookmyung Women's University) ;
  • Shin, Hyun Taek (College of Pharmacy, Sookmyung Women's University)
  • 장진경 (가톨릭대학교 인천성모병원 약제팀) ;
  • 김해숙 (강릉아산병원 약제팀) ;
  • 손현순 (숙명여자대학교 약학대학) ;
  • 박찬미 (건강보험심사평가원) ;
  • 김주상 (가톨릭대학교 인천성모병원 호흡기내과) ;
  • 정복현 (강릉아산병원 호흡기내과) ;
  • 지은희 (가천대학교 약학대학) ;
  • 조정환 (숙명여자대학교 약학대학) ;
  • 신현택 (숙명여자대학교 약학대학)
  • Received : 2014.02.07
  • Accepted : 2014.03.21
  • Published : 2014.03.31

Abstract

Purpose: The aim of this study was to investigate drug prescription patterns for the treatment of asthma and chronic obstructive pulmonary disease (COPD) patients in Korea. Methods: Ambulatory adult patients who were diagnosed and received treatment for the asthma (ICD-10 code J45) or COPD (ICD-10 code J44) from January 2009 to September 2011 in two independent secondary hospitals in Korea were enrolled in this study. Prescribed drug lists were generated based on the evidence-based guidelines and prescribed drug dosage forms were identified from the patient medical records and computerized drug prescription databases of the study centers. Results: Total numbers of asthma and COPD patient enrolled in this study were 2,432 and 2,615, respectively. Individual prescription-based accumulated numbers of patient were 12,021 for asthma and 16,584 for COPD. The most commonly prescribed three drugs were oral predisolone, oral formoterol and oral montelukast for asthma and oral formoterol, oral doxofylline and inhaled tiotropium for COPD. Frequencies of oral drugs were 83.4% and 63.3% while inhalers were 16.4% and 30.2%, for asthma and COPD, respectively. Conclusion: The oral treatment was prescribed more in asthma and COPD patients than inhalers. To enhance the compliance of evidence-based guidelines for these chronic airway diseases, more realistic and specific strategies to increase the use of inhalers recommended as primary treatment options for asthma and COPD would be required.

Keywords

References

  1. Holt S, Masoli M, Beasley R. The use of the selfmanagement plan system of care in adult asthma. Prim Care Respir J 2004; 13(1): 19-27. https://doi.org/10.1016/j.pcrj.2003.11.001
  2. Centers for Disease Control and Prevention, Ministry of Health & Welfare. 2010 National health statistics. 2010.
  3. Kim YK, Kim SH, Tak YJ, et al. High prevalence of current asthma and active smoking effect among the elderly. Clin Exp Allergy 2002; 32: 1706-12. https://doi.org/10.1046/j.1365-2222.2002.01524.x
  4. Status of national health insurance benefits 2004-2010. Available at http:/www.nhic.or.kr. Last accessed on 22 November, 2012.
  5. Bureau of the Census. Cause of death statistics. Korean Statistical Information Service. Available at http://kosis.kr. Last accessed on 22 November, 2012.
  6. Kim CY, Park HW. Ko SK, et al. The financial burden of asthma: a nationwide comprehensive survey conducted in the republic of Korea. Allergy Asthma Immunol Res 2011; 3(1): 34-8. https://doi.org/10.4168/aair.2011.3.1.34
  7. Yoo KH, Jeong JW, Yoon HJ, et al. The status of perception of asthma treatment by primary care physicians and the evaluation of the usefulness of easy asthma managment program. Korean J Asthma Allergy Clin Immunol 2006; 26: 282-8.
  8. Burge PS, Calverley PM, Jones PW, et al., Randomised, double blind, placebo controlled study of fluticasone propionate in patients with moderate to severe chronic obstructive pulmonary disesae: the ISOLDE trial. BMJ 2000; 320: 1297-303. https://doi.org/10.1136/bmj.320.7245.1297
  9. Lung Health Study Rearch Group, Effect of inhaled triamcinolone on the decline in pulmonary function in chronic obstructive pulmomary disease. N Engl J Med 2000; 343: 1902-9. https://doi.org/10.1056/NEJM200012283432601
  10. The Korean Academy of Tuberculosis and Respiratory Disease/Committee for Asthma Treatment Guideline. Treatment guideline for asthma. 2005.11. Available at http:// www.lungkorea.org/thesis/file/%C3%B5%BD%C4%C1% F8%B7%E1%C1%F6%C4%A7(05.11.7).pdf
  11. The Korean Academy of Tuberculosis and Respiratory Disease/Committee for Chronic Obstructive Pulmonary Disease Guideline. Treatment guideline for Chronic Obstructive Pulmonary Disease. 2005.11. Available at http://www.lungkorea.org/thesis/file/COPD%C1%F8% B7%E1%C1%F6%C4%A7(05.11.7).pdf
  12. Cho SH, Kim YK, Chang YS, et al. Asthma insights and reality in Korea. Kor J Med 2006; 70(1): 69-77.
  13. Rabe KF, Adachi M, Lai CK, et al. Worldwide severity and control of asthma in children and adults: the gloval asthma insights and reality surveys. J Allergy Clin Immunol 2004; 114: 40-47. https://doi.org/10.1016/j.jaci.2004.04.042
  14. Park MJ, Choi CW, Kim SJ, et al. Survey of COPD Management among the Primary Care Physicians in Korea. Tuberc Respir Dis 2008; 64: 109-24. https://doi.org/10.4046/trd.2008.64.2.109
  15. Newsmp. Article related guidelines of inhalers for asthma treatment (11 March, 2014). Available at http://www. newsmp.com/news/articleView.html?idxno=117339
  16. WHO International Classification of Disease (ICD)-10. Available at http://apps.who.int/classifications/icd/en/.
  17. Global Initiative for Asthma. Pocket Guide for Asthma Management and Prevention. 2010. Available at http:// www.ginasthma.org/local/uploads/files/GINA_Pocket 2013_May15.pdf
  18. Global Initiative for Chronic Obstructive Lung Disease. Pocket Guide to COPD Diagnosis, Managment, and Prevention. 2010. Available at http://www.goldcopd.org/ uploads/users/files/GOLD_Pocket2014_Jan30.pdf
  19. Lee GD, Doh SR, Lee JS, et al. Trends and factors in health care utilization of patients with chronic obstructive pulmonary disease in Korea: A nationwide survey from 1990 through 2008. Tuberc Respir Dis 2011; 70: 307-14. https://doi.org/10.4046/trd.2011.70.4.307
  20. Lee EK, Bae EY, Park EJ, et al. Pattern of asthma management by primary physicians in seoul. Tuberc Respir Dis 2003; 55: 165-74. https://doi.org/10.4046/trd.2003.55.2.165
  21. Park MJ, Choi CW, Kim SJ, et al. Survey of COPD management among the primary care physicians in Korea. Tubec Respir Dis 2008; 64: 109-24. https://doi.org/10.4046/trd.2008.64.2.109