Tuesday, 17 April 2012

Alternative Therapies Aren't Used as Substitutes for Asthma Meds: Study

Almost one in five parents has turned to an alternative or complementary medicine or treatment for their child's asthma, but new research has found that parents are not abandoning traditional treatments in the process.

"We found that there were really no differences between the groups that used complementary and alternative medicine and those that didn't [in terms of adherence]. It seems that parents are using these therapies as complementary medicine alongside prescribed asthma treatments," said study author Dr. Julie Philp, a pediatrician and a dermatology resident at the University of California, San Francisco.
Results of the study were released online and published in the May issue of Pediatrics.

Complementary and alternative medicine includes health care practices that aren't usually included in more conventional medicine. Such treatment may include herbal remedies, acupuncture and homeopathy. The use of complementary and alternative medicine is on the rise among children, according to background information in the article. Other research has found that children with respiratory problems may be even more likely to be given an alternative medicine treatment.

Health care providers have been concerned that parents who turn to complementary and alternative medicine therapies might cut back on the use of standard medications (for example, the daily use of controller medications such as inhaled corticosteroids). Daily controller medications typically have low adherence rates, even without the addition of other medications or therapies, according to the study.
To assess whether or not the use of complementary and alternative medicines might further lower adherence rates to those medications, Philp and her colleagues used data from a larger study that was designed to assess the impact of physician education on the management of asthma.
The new study included 187 parents of children on daily controller medication for their asthma. The study population was predominantly white and 61 percent had a college education or higher. Eighteen percent of the parents said they had turned to some form of complementary or alternative medicine for their children.

The researchers specifically asked about the use of herbs, teas, dietary changes, breathing exercises, meditation, prayer, massage, biofeedback or homeopathy.

Each week, the children in the study missed an average of 7.7 percent of their daily controller medication doses. The researchers found that the use of complementary or alternative medications didn't seem to affect that rate.

"The data from this study suggest that complementary and alternative medicine use is not necessarily 'competitive' with conventional asthma therapies; families may incorporate different health belief systems simultaneously in their asthma management," the study authors concluded.
Experts still urge parents to be wary when considering alternative medicines or treatments for their child's asthma.

"I would urge parents to proceed with caution any time they use an alternative treatment. They're not magical, and if something works to improve symptoms, then it has the potential to hurt you, too," said Dr. Raoul Wolfe, medical director of asthma medicine at La Rabida Children's Hospital in Chicago.
He added that people should talk with their child's doctor to make sure whatever alternative therapy they might want to try doesn't have the potential to interact with standard medications.
Philp said that one of the study's aims is to get pediatricians to open up a dialogue with patients and their parents. For parents, she recommends, "Share with your child's health care provider what your beliefs are and work with the doctor to find complementary and alternative therapies that are safe. The doctor, parent and child should be a team working together."

Jonathan Feldman, an assistant clinical professor of epidemiology and population health at Albert Einstein College of Medicine in New York City, agreed that parents and providers need to talk about alternative medicine. "The number-one message is the need for open communication," he said. "What we, and others have found, is that if doctors don't ask, families won't tell. Families don't bring up alternative medicine use with providers. It's sort of taboo. But, parents should be more open about what they're giving the kids."

And, Feldman added that providers need to be sure they're familiar with the types of alternative treatments that their patient populations might be using. For example, he said that in his area, which has a large black and Puerto Rican population, one of the most common alternative treatments that people use is a menthol chest rub. But, he said, patients often don't think of this as an alternative treatment; it's just something that their families have always used. So it's important for health care providers to be specific when they ask about alternative treatments, he explained.

SOURCES:
Julie Philp, M.D., pediatrician and dermatology resident, University of California, San Francisco; Raoul Wolf, M.D., medical director, asthma medicine, La Rabida Children's Hospital, Chicago; Jonathan Feldman, Ph.D., assistant clinical professor, epidemiology and population health, Albert Einstein College of Medicine, and associate professor, psychology, Yeshiva University, New York City; May 2012, Pediatrics

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