Data were extracted from the medical files of children enlisted in the four academic primary healthcare centres in Utrecht, which are linked to the University Medical Center Utrecht. When data in the electronic medical files were incomplete, data were instead extracted from the paper medical records from health centres where patients were enlisted previously. Data on medication were obtained from the four pharmacies associated with the participating healthcare centres.
How this fits in
Previous studies have indicated that asthma in children is probably overdiagnosed. The extent to which this occurs has not previously been assessed. This study is the first to investigate whether an asthma diagnosis and/or treatment given to children is preceded by a diagnostic process as recommended in the guidelines. It shows the need to follow the correct diagnostic strategy when diagnosing asthma in children.
Patients were included who were aged 6–18 years on 15 April 2013 and who had received a diagnosis of asthma or were treated as having asthma with chronic inhalation medication. The asthma diagnosis was considered established when the International Classification of Primary Care (ICPC) code for asthma (ICPC R96) was applied. A child was defined as using chronic inhalation medication when the prescription was filled by the pharmacy at least three times in the last 3 years. Note that one prescription contains enough medication to last for 3–6 months. Therefore children who are only in need of inhalation medication during the winter months would have sufficient medication with one prescription.
