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Use of Complementary and Alternative Therapies Does Not Negatively Affect Inhaled Steroid Adherence: Presented at ATS

By Bonnie Darves

SEATTLE, WA -- May 23, 2003 -- Patients with asthma who use complementary and alternative medicine (CAM) are not less likely to adhere to prescribed inhaled corticosteroids (ICS) treatment, according to a new study.

This may come as good news to physicians, who already struggle with poor ICS adherence in their patients (which may be responsible for an estimated 50% of asthma deaths, according to research) and who are concerned that patients who seek CAM therapies are less likely to comply with recommended ICS treatment.

Results of the new study, conducted at the University of Pennsylvania Pulmonary & Critical Care Division in Philadelphia, United States, were presented here May 20^th at the American Thoracic Society International Conference. "We know that people in the United States are increasingly using CAM. So many physicians have been concerned that patients' use of unorthodox treatments, when they decide to pursue their own disease management approaches, may cause some underutilization of prescribed therapies," said lead researcher Maureen George, MSN., coordinator of the division's Comprehensive Care Program. "But that's not what we are finding." She added that other studies of patients with cancer, AIDS, and hypertension have had essentially the same findings: that patients who pursue CAM tend to use prescribed "conventional" therapies in tandem.

The researchers enrolled 84 adults, mean age of 48 years and predominantly female, with moderate or severe asthma in the 42-day study. They sought to determine whether those who reported using CAM had poorer adherence to ICS treatment than those who did not use alternative therapies. The 21 patients who reported CAM use were compared over the study period to 63 who did not use CAM. Electronic monitoring, of dosages prescribed to doses recorded, was used to determine adherence.

Little difference was seen between the two groups, Ms George said, but the patients who reported CAM use had slightly better adherence rates -- 63% versus 58% -- than those who did not use CAM. Ms George expressed concern that CAM use may have been underreported in the patients, perhaps because of their reluctance to disclose concerns CAM use to their physicians. "These [CAM usage] numbers were slightly below those reported in the general population, so you wonder about whether some patients who use CAM chose not to disclose that," she said. She admitted that a larger sample size would be necessary to definitively determine whether ICS adherence is influenced by CAM use.

One underlying message of the study results, Ms George said, is that physicians should take a more active role in discussing CAM use with patients. "We know that many patients are using CAM, so if they felt they had their providers' 'permission' to integrate CAM with conventional therapies, there might be better partnerships between physicians and patients," she said.


[Study title: Inhaled Steroid Adherence Does Not Differ between Patients Who Do or Do Not Use Complementary and Alternative Medicine (CAM). Poster 509]

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