Document Detail


Use of herbal remedies and adherence to inhaled corticosteroids among inner-city asthmatic patients.
MedLine Citation:
PMID:  20306816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Complementary and alternative medicines (CAM), such as herbal remedies, are widely used by patients with chronic diseases, such as asthma. However, it is unclear whether use of the herbal remedies is associated with decreased adherence to inhaled corticosteroids (ICSs), a key component of asthma management.
OBJECTIVE: To examine the association among use of herbal remedies, adherence to prescribed ICSs, and medication and disease beliefs.
METHODS: We surveyed 326 adults with persistent asthma who received care at 2 inner-city outpatient clinics. Patients were asked about CAM use (teas, herbs, and rubs) for the treatment of asthma in the prior 6 months. Medication adherence was assessed using the Medication Adherence Report Scale, a validated self-report measure. Univariate and multiple regression analyses were used to assess the relationship among herbal remedy use, adherence to ICSs, and medication and disease beliefs.
RESULTS: Overall, 25.4% (95% confidence interval, 20%-30%) of patients reported herbal remedy use. Univariate analyses showed that herbal remedy use was associated with decreased ICS adherence and increased asthma morbidity. In multivariable analysis, herbal remedy use was associated with lower ICS adherence (odds ratio, 0.4; 95% confidence interval, 0.2-0.8) after adjusting for confounders. Herbal remedy users were also more likely to worry about the adverse effects of ICSs (P = .01).
CONCLUSIONS: The use of herbal remedies was associated with lower adherence to ICSs and worse outcomes among inner-city asthmatic patients. Medication beliefs, such as worry about ICS adverse effects, may in part mediate this relationship. Physicians should routinely ask patients with asthma about CAM use, especially those whose asthma is poorly controlled.
Authors:
Angkana Roy; Linda Lurslurchachai; Ethan A Halm; Xiu-Min Li; Howard Leventhal; Juan P Wisnivesky
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology     Volume:  104     ISSN:  1081-1206     ISO Abbreviation:  Ann. Allergy Asthma Immunol.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-03-23     Completed Date:  2010-05-24     Revised Date:  2011-09-26    
Medline Journal Info:
Nlm Unique ID:  9503580     Medline TA:  Ann Allergy Asthma Immunol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  132-8     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Mount Sinai School of Medicine, New York, New York, USA. angkana.roy@mssm.edu
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MeSH Terms
Descriptor/Qualifier:
Administration, Inhalation
Adrenal Cortex Hormones / therapeutic use*
Adult
Asthma / drug therapy*,  epidemiology,  physiopathology
Female
Humans
Male
Medication Adherence
Middle Aged
New Brunswick
New York City
Plant Preparations / therapeutic use*
Questionnaires
Treatment Outcome
Urban Population*
Grant Support
ID/Acronym/Agency:
K08 HS013312/HS/AHRQ HHS; M01 RR000071-458307/RR/NCRR NIH HHS; P01 AT002647-04/AT/NCCAM NIH HHS; P01 AT002647-040002/AT/NCCAM NIH HHS
Chemical
Reg. No./Substance:
0/Adrenal Cortex Hormones; 0/Plant Preparations

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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