Complementary and alternative medicine (CAM) use among children with current asthma☆,☆☆
Introduction
Asthma is a common chronic disease that affects more than 300 million persons world-wide and 25 million persons in the United States, including 1 in 10 U.S. children (10%) (Centers for Disease Control and Prevention, 2011). Asthma is not an episodic disease but rather a chronic condition with complex etiology including chronic underlying airway inflammation and immunological interplay with the environment. Chronic inflammation has been demonstrated in allergic and non-allergic asthma (Bousquet et al., 2000). Poorly controlled asthma and asthma exacerbation leading to airway remodeling and decline in lung function have been reported (O'Byrne et al., 2009). While primary prevention is limited, maintaining good control and preventing exacerbation have been emphasized in leading asthma guidelines. Low doses of inhaled corticosteroid are prescribed as the first-line preventive treatment for patients with persistent asthma (National Asthma Education and Prevention Program, 2007). When considering asthma outcomes, prevention efforts also should include protection from the adverse effects of therapies (Shen et al., 2011).
Despite growing interest, the prevalence of complementary and alternative medicine (CAM) use among children with asthma is unknown. Prior studies on CAM use among children with asthma focused on groups recruited from hospitals, clinics, or confined geographic areas (Braganza et al., 2003, Ottolini et al., 2001, Reznik et al., 2002).
We analyzed data from the Asthma Call Back Survey (ACBS) 2006–2008 (23, 31, and 32 participating states for each respective survey year) to estimate the prevalence of CAM use among children with current asthma in participating states. The telephone-based ACBS is the most comprehensive state-level, population-based asthma survey to date. We described the most commonly used therapies, examined the demographic characteristics of CAM users, assessed the association of CAM use with asthma control, and explored health-care–access characteristics associated with CAM use.
Section snippets
Methods
The methods we used were described previously (Marino and Shen, 2010). The Behavioral Risk Factor Surveillance System (BRFSS) is the world's largest, ongoing, telephone health-survey system that has tracked health conditions and risk behaviors in the United States yearly since 1984 (Centers for Disease Control and Prevention, 2011). The ACBS, which is a follow-up survey to the BRFSS, collects in-depth information on asthma-related factors such as medication use, asthma self-management, and
CAM use by demographic and asthma-related characteristics
A total of 8447 children were represented in the 2006–2008 Asthma Call-Back Survey. Of these, 2623 were not asked about CAM use in the past year because they did not currently have asthma. Of the 5632 respondents with current asthma, 5435 (97%) had complete data for CAM use and were included in the analysis. Overall, CAM use was reported for 26.7% (95% CI = 24.5–29.0) of children with current asthma. Demographic and asthma-related characteristics by CAM use are shown in Table 1. When compared to
Discussion
Among children with current asthma in ACBS-participating states from 2006 through 2008, 27% (95% CI = 25–29) used CAM therapy in the past 12 months as part of their asthma treatment. The prevalence of CAM use was an estimated 34% (95% CI = 29–39) among children with poorly controlled asthma. The most commonly used CAM therapies were breathing techniques, vitamins, and herbs or herbal products.
The results showed that poor asthma control was strongly associated with reported CAM use. Our findings are
Conflict of interest statement
The authors declare that there are no conflicts of interest.
Acknowledgment
The authors thank Jeanne Moorman, Paul Garbe, Dana Flanders and 3 anonymous reviewers for their valuable comment.
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This paper responds to the Call for Papers to Preventive Medicine, an international journal, for a themed issue on complementary, alternative, and integrative therapies for chronic disease.
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The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.