Alert to CAM use in asthma

Researchers from Canada say that physicians should be aware of the high prevalence of complementary and alternative medicine (CAM) use among patients with asthma.

Their study, published in the BMJ Open, shows that over one-third of patients with asthma, particularly those with poor symptom control, use therapies such as herbal medicines, breathing exercises, and vitamins to treat their condition.

“Given the uncertain benefits, potential side effects and possible drug interactions of CAMs, it is important for physicians to be aware of CAM usage among their patients and understand the reasons of use,” say authors Mohsen Sadatsafavi (University of British Columbia, Vancouver) and colleagues.

The study involved 486 adults with self-reported physician-diagnosed asthma. Overall, 179 (36.8%) patients reported using CAMs in the prior 12 months.

In multivariate analysis, the team found that the 41.6% of patients with currently uncontrolled asthma according to Global Initiative for Asthma criteria were 2.25-fold more likely to have used CAMs than patients with controlled symptoms; partially controlled asthma was not associated with CAM use.

Women were also more likely to use CAMs than men, at a 1.66-fold greater odds.

Noting that controller medication use was not linked to CAM use, the team says it is possible that CAM users are a mixture of those who use it to supplement their conventional treatment and those who use it as a substitute therapy.

However, the researchers caution that the cross-sectional nature of their study leaves them unable to draw conclusions about causality from their observations.

“Overall, CAM use might be a sign of patients’ lack of satisfaction with asthma treatment, prompting the care provider to re-evaluate asthma management,” they suggest.

“Further research is required to evaluate the economic impact of CAM usage, to further examine other potential factors determining the use of CAMs such as individuals’ value systems and beliefs, access to care, health literacy and quality of life, and to rigorously study the causal interactions between CAM use, asthma control and use of controller medications,” the team concludes.

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