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Eliminated patient fee and changes in dispensing patterns of asthma medication in children-An interrupted time series analysis

机译：消除儿童哮喘药物分配模式的患者费用和变化 - 中断时间序列分析

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In 2016, all prescription drugs included in the reimbursement system in Sweden were made available for children (age 0-17 years) without any patient fees. Our aim was to estimate the association between this intervention and the dispensing patterns of asthma medications among children. Dispensing data on asthma medications for all children living in Stockholm County during 2014-2017 were selected to include two years before (January 2014-December 2015) and after (January 2016-December 2017) the intervention. In an uncontrolled before and after study, the measures of utilization were as follows: the proportion of children with at least one dispensed asthma medication (prevalence); the number of children initiated on treatment after an 18-month drug-free period (incidence); the number of defined daily doses (DDDs) dispensed per child; and the number of children with at least two prescriptions with controller medication (inhaled corticosteroid or leukotriene receptor antagonist) dispensed during 18 months (persistence). In an interrupted time series (ITS) analysis, all measures were included except for persistence. Socio-economic status was defined using Mosaic data. The prevalence increased after the intervention (from 11.9% to 13.0%). However, the ITS analysis showed a positive trend already before the intervention, and consequently, the increase was not attributable to the intervention. For incidence, similar patterns were observed. There was an increase in dispensed volumes related to the intervention, 46.3 DDDs/child/month before and 51.1 after the intervention (P-value 0.01). The proportion of children with persistent asthma medication increased from 46.0% to 51.9% in children with low socio-economic status. In conclusion, the intervention was only modestly associated with changes in the dispensing patterns of asthma medication, with the volume dispensed per child increasing slightly, particularly in children with low socio-economic status.
机译：2016年，瑞典报销制度中包含的所有处方药都可用于儿童（0-17岁），没有任何患者的费用。我们的目标是估计该干预措施与儿童哮喘药物的分配模式之间的关联。在2014 - 2017年期间，在斯德哥尔摩县居住的所有儿童的哮喘药物上的数据被选中以包括两年（2015年1月2015年1月）和（2016年1月至2017年1月）的干预。在学习前后不受控制的情况下，利用措施如下：至少有一个分配的哮喘药物（患病率）的儿童的比例;在18个月的无药剂期（发病率）后发起的儿童人数;每名儿童分配定义的日常剂量（DDDS）的数量;以及在18个月（持久性）期间分配了至少两种具有控制器药物（吸入的皮质类固醇或白三烯受体拮抗剂）的儿童的数量。在一个中断的时间序列（其）分析中，除了持久性之外，包括所有措施。使用马赛克数据定义社会经济地位。干预后流行增加（从11.9％到13.0％）。然而，它的分析显示了在干预前已经存在的积极趋势，因此，增加不会归因于干预。对于发病率，观察到类似的模式。与干预有关的分配量，46.3个DDDS /儿童/儿童/月前，干预后51.1（P值0.01）。持续性哮喘药物的儿童比例从社会经济地位低的儿童增加到46.0％至51.9％。总之，干预剧性与哮喘药物的分配模式的变化急性有关，每个儿童分配的体积略微增加，特别是社会经济地位低的儿童。

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