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Improving care in paediatric asthma: patients, prescriptions, pharmacovigilance, pathogens, and particles

14 November 2008

PhD ceremony: T.W. de Vries, 16.15 uur, Academiegebouw, Broerstraat 5, Groningen

Thesis: Improving care in paediatric asthma: patients, prescriptions, pharmacovigilance, pathogens, and particles

Promotor(s): prof. L.T.W. de Jong-Van den Berg, prof. E.J. Duiverman

Faculty: Mathematics and Natural Sciences


This thesis deals with some of the many aspects of paediatric asthma care. Using prescription data we found that respectively 2%, 3%, and 0.7% of the children are treated with corticosteroids because of asthma, eczema, and allergic rhinitis. These numbers are lower than found in other epidemiological studies. We found that many children with asthma are not treated according to the guidelines. Intervention using pharmacies improved this. Another finding was that about 40% of the children received a too low starting dose of inhaled corticosteroids (ICS).
Using data of the Dutch Pharmacovigilance Centre Lareb, we discovered that ICS could cause hypertrichosis; further analysis with WHO-data confirmed this. Behavioural problems were relatively often reported and therefore we compared the number of children with asthma and children under the care of the otolaryngologist and healthy children for behavioural problems and found no differences.
Furthermore, we studied survival of pathogenic bacteria in spacers. Some bacteria could survive in spacers, unless these were made of steel. A study to the number of spacers of children visiting the outpatient clinic to contamination with pathogenic bacteria showed that in practice contamination is rare.
The yield of respirable particles of ICS was studied and we found that during the life span the yield of fluticasone 125 µg decreased significantly. Laser diffraction analysis revealed that the particle size of ICS-aerosols was not influenced by life span, humidity and flow. The aerosols with hydrofluoroalkane beclomethasone and ciclesonide had the highest yield of respirable particles.

Last modified:15 September 2017 3.37 p.m.

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