Complementary and Alternative Medicine Use and Adherence With Pediatric Asthma Treatment

Abstract

BACKGROUND AND OBJECTIVE: Complementary and alternative medicine (CAM) use for pediatric asthma is increasing. The authors of previous studies linked CAM use with decreased adherence to conventional asthma medicines; however, these studies were limited by cross-sectional design. Our objective was to assess the effect of starting CAM on pediatric adherence with daily asthma medications. METHODS: We used a retrospective cohort study design. Telephone surveys were administered to caregivers of patients with asthma annually from 2004 to 2007. Dependent variables were percent missed doses per week and a previously validated “Medication Adherence Scale score.” Independent variables included demographic factors, caregiver perception of asthma control, and initiation of CAM for asthma. We used multivariate linear regression to assess the relationship between medication adherence and previous initiation of CAM. RESULTS: From our longitudinal data set of 1322 patients, we focused on 187 children prescribed daily medications for all 3 years of our study. Patients had high rates of adherence. The mean percent missed asthma daily controller medication doses per week was 7.7% (SD = 14.2%). Medication Adherence Scale scores (range: 4–20, with lower scores reflecting higher adherence) had an overall mean of 7.5 (SD = 2.9). In multivariate analyses, controlling for demographic factors and asthma severity, initiation of CAM use was not associated with subsequent adherence (P > .05). CONCLUSIONS: The data from this study suggest that CAM use is not necessarily “competitive” with conventional asthma therapies; families may incorporate different health belief systems simultaneously in their asthma management. As CAM use becomes more prevalent, it is important for physicians to ask about CAM use in a nonjudgmental fashion.

Preventive asthma medication discontinuation among children enrolled in fee-for-service Medicaid

“…This may be explained in part by the short duration of usage that we measured here, although low initiation of preventive asthma medications may also be a factor. Consistent with other studies [9,[34][35][36][37][38][39][40], our results indicate that usage falls among adolescents, typically within an age range when children assume responsibility for taking their own medications.…”

“…Covariates were chosen that have been found in other research to be predictive of discontinuation: age at first preventive asthma medication claim, sex [9,[34][35][36][37][38][39][40], race/ ethnicity [4,9,10,21,38,41], urbanicity [41], geographic location [9], reported highest educational attainment by any family member [35,37,39,42], family structure [39,40,43], reported health status [9], presence of chronic conditions besides asthma [7,35], healthcare out-of-pocket costs [12], presence of a primary care provider [5,6], and preventive asthma medication regimen [7,20,36].…”

Complementary and alternative medicine in pulmonology

“…They include vitamins, minerals, and herbal medications, and may come in many forms such as pills, capsules, tablets, powders, or liquids (teas, decoctions, and tinctures). In most surveys, supplements are the most commonly used form of CAM for pulmonary problems [8]. However, dietary supplements, including herbal medications, do not have the same government oversight as conventional medications, and are treated more like food products [11].…”

“…This variance may depend on the degree of asthma control, geographic location, and parental attitudes toward CAM [7]. One longitudinal analysis in pediatrics showed no effect of CAM use on future adherence to controller medication [8].…”

Medication Use in Australian Children with Asthma: User’s Perspective

“…Strategies to minimize medication costs should be another. Post-education provision healthcare professionals should negotiate a child's treatment, taking also into account parental views toward medicines and previous use of self-medication for their child (66,67). A study revealed that CAM use is not necessarily "competitive" with conventional asthma therapies; families may incorporate different health belief systems simultaneously in their asthma management.…”