Asthma medicines often not prescribed as national guidelines...( COLUMBUS Ohio More than a decade af...),Health

COLUMBUS, Ohio More than a decade after national guidelines were issued for asthma treatment, some patients still dont receive prescriptions for the inhalers that experts say offer the safest and most effective long-term control of the disease, a new study suggests.

Physicians prescribing practices based on expert recommendations improved between 1998 and 2002 overall. But the study showed the use of the medications that are considered most effective in controlling the condition began to decline after 2003, leading researchers to suspect doctors might be too cautious in their prescribing practices.

Treatment disparities based on age and race were also evident. The elderly and minorities tended to be less likely to be prescribed the long-acting controller medications called for in the guidelines, according to Ohio State University research examining prescribing trends over a seven-year period.

Patients also were still being prescribed short-term symptom relief medications that are so outdated, they hardly even deserve to be prescribed anymore, said senior study author Rajesh Balkrishnan, the Merrell Dow professor of pharmacy at Ohio State. The guidelines stress that patients who are asthmatic need to be on some type of controller medications. Just using symptomatic relief medications is not enough.

The guidelines, issued by the National Heart, Lung and Blood Institute (NHLBI) in 1997, recommend using long-term controller medications for patients with persistent asthma and short-term reliever medications for acute symptoms only.

Physician training could affect prescribing practices, Balkrishnan said. Only a third of the patients in the survey were treated by lung or allergy specialists. That suggests most asthma patients are treated by generalists who might need to be further educated about asthma and other specialty medical conditions to prescribe the most effective treatments.

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