Perceptions of complementary/alternative medicine use and influence on evidence-based asthma medicine adherence in Malaysian children

Abstract

Complementary and alternative medicine (CAM) is widely used especially in Asia including for childhood asthma. The use of CAM could influence adherence to evidence-based (E-B) medicine. We explored the views of carers of Malaysian children with asthma regarding the use of CAM for childhood asthma, and its relationship with self-reported adherence to E-B medicine. We used a screening questionnaire to identify children diagnosed with asthma from seven suburban primary schools in Malaysia. Informed consent was obtained prior to the interviews. We conducted the interviews using a semi-structured topic guide in participants’ preferred language (Malay, Mandarin, or Tamil). All interviews were audio-recorded, transcribed verbatim and coded using Nvivo. Analysis was performed thematically, informed by the Necessity-Concerns Framework. A total of 46 carers (16 Malays, 21 Indians, 9 Chinese) contributed to 12 focus groups and one individual interview. We categorised participants’ as ‘Non-CAM’; ‘CAM’; or ‘combination’ user. Cultural practices and beliefs in the efficacy of CAM resulted in widespread use of CAM. Most carers used CAM as ‘complementary’ to E-B medicine. Concerns about dependence on or side effects of E-B treatment influenced carers’ decisions to rely on CAM as an ‘alternative’, with an important minority of accounts describing potentially harmful CAM-use. Healthcare professionals should discuss beliefs about the necessity for and concerns about use of both E-B medicine and CAM, and provide balanced information about effectiveness and safety. The aim is to improve adherence to regular E-B preventer medication and prevent delays in seeking medical advice and harmful practices associated with CAM.

Perceptions of childhood asthma and its control among Malays in Malaysia: a qualitative study

“…This is worrisome as parents might not recognise asthma severity nor understand the danger of such action. This is similar to other studies 13,37 whereby parents tried various ways to improve children's asthma control, such as the use of CAM and the home nebuliser. Parents feared the use of preventer medication for asthma would cause side effects and dependency, a common concern in Asian and western countries [38][39][40] .…”

“…Healthcare providers should be made aware of dangerous self-management practices which may be influenced by cultural and religious beliefs 43 . Parents and children also need to be educated on asthma and evidence-based management taking into account the cultural influence and myths 13 as parents were the primary caregivers for the children until they reached the age of majority, which is 18 years old in Malaysia 44 as children were reliant on parents' selfmanagement practices.…”

“…Some parents and physicians tend to underestimate the severity of children's asthma and overestimate their asthma control 12 . Asthma self-management is influenced by one's perception of asthma 11 which may vary between ethnic groups due to diverse culture 13,14 . For instance, during the fasting period, Muslims would adjust their medication to enable them to fast as some Muslims are taught the use of an inhaler invalidates the fast 15 .…”

Parental satisfaction and perception of Progress in influencing the Practice of complementary health approaches in children with autism: a cross sectional survey from Negeri Sembilan, Malaysia

“…Perhaps parents of ASD children were more cautious when using CHA compared to parents of children with the above diseases. A small minority of parents may also be concern of the potential harm of the use of CHA [34] and only consider the option when truly necessary.…”

Acil Servise Solunum Sistemi Şikayetiyle Başvuran Hastalarda Tamamlayıcı ve Alternatif Tıp Kullanımının Değerlendirilmesi

“…TAT, özellikle kronik, tekrarlayan ve tedavisi olmayan durumlar başta olmak üzere konvansiyonel tedaviye alternatif bir tedavi olarak kabul edilmekte ve dünya çapında kullanımı artmaktadır (6)(7)(8)(9). TAT'ın astım başta olmak üzere en fazla akciğer problemlerinde kullanıldığı bilinmektedir (10,11). Astım olan çocuklarda geleneksel tedavilerle birlikte % 51-89 oranında kullanım bildirilmiştir (12).…”