Disparities in complementary alternative medicine use and asthma exacerbation in the United States

J Asthma. 2020 Aug;57(8):866-874. doi: 10.1080/02770903.2019.1614615. Epub 2019 May 15.

Abstract

Background: Complementary and alternative medicines (CAM) are associated with poor asthma medication adherence, a major risk factor for asthma exacerbation. However, previous studies showed inconsistent relationships between CAM use and asthma control due to small sample sizes, demographic differences across populations studied, and poor differentiation of CAM types.Methods: We examined associations between CAM use and asthma exacerbation using a cross-sectional analysis of the 2012 National Health Interview Survey. We included adults ≥18 years with current asthma (n = 2,736) to analyze racial/ethnic differences in CAM use as well as the association between CAM use and both asthma exacerbation and emergency department (ED) visit for asthma exacerbation across racial/ethnic groups. We ran descriptive statistics and multivariable logistic regressions.Result: Blacks (OR = 0.63 [0.49-0.81]) and Hispanics (OR = 0.66 [0.48-0.92]) had decreased odds of using CAM compared to Whites. Overall, there was no association between CAM use and asthma exacerbation (OR = 0.99 [0.79-1.25]) but the subgroup of 'other complementary approaches' was associated with increased odds of asthma exacerbation among all survey respondents (1.90 [1.21-2.97]), Whites (OR = 1.90 [1.21-2.97]), and Hispanics (OR = 1.43 [0.98-2.09). CAM use was associated with decreased odds of an ED visit for asthma exacerbation (OR = 0.65 [0.45-0.93]). These associations were different among racial/ethnic groups with decreased odds of ED visit among Whites (OR = 0.50 [0.32-0.78]) but no association among Blacks and Hispanics.Conclusion: We found that both CAM use and the association between CAM use and asthma exacerbation varied by racial/ethnic group. The different relationship may arise from how CAM is used to complement or to substitute for conventional asthma management.

Keywords: Asthma; National Health Interview Survey (NHIS); complementary and alternative medicine (CAM); health disparity; herbal; minorities.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Anti-Asthmatic Agents / therapeutic use
  • Asthma / diagnosis*
  • Asthma / ethnology
  • Asthma / therapy
  • Black or African American / statistics & numerical data
  • Complementary Therapies / adverse effects
  • Complementary Therapies / statistics & numerical data*
  • Cross-Sectional Studies
  • Emergency Service, Hospital / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Health Surveys / statistics & numerical data
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Medication Adherence / ethnology
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Racial Groups
  • Socioeconomic Factors
  • Symptom Flare Up*
  • United States
  • White People / statistics & numerical data
  • Young Adult

Substances

  • Anti-Asthmatic Agents