THE USE OF COMPLEMENTARY ALTERNATIVE MEDICINE FOR THE TREATMENT OF ASTHMA IN THE UNITED-STATES/

Despite our advances in the diagnosis and treatment of asthma, the inc idence of mortality is increasing in developed countries. As patients and health care providers seek new options for the treatment and preve ntion of asthma, various complementary and alternative medical therapi es are being used. With funding from the Office of Alternative Medicin e, National institutes of Health, our goal was to identify the type an d prevalence of complementary and alternative treatments for asthma in use in the United States in order to establish a research agenda for the study of the most promising therapies. A survey was developed by a n expert panel. After undergoing a preliminary round of testing and im provement, the survey was then sent along with a postage-paid return e nvelope as inserts in the May 1996 issue of Alternative Therapies in H ealth and Medicine, a peer-reviewed periodical of complementary and al ternative medical research and scholarly activity; 10,000 surveys were distributed We asked that only those who treated asthma respond. The surveys were designed to identify characteristics of the respondent, t heir particular practice type, use of complementary and alternative me dicine, or conventional medicine in general, patient characteristics a nd numbers, and their use of 20 specific potential therapies to treat asthma. A total of 564 surveys were returned. The 5.64% response rate was low but was reflective of the demographics of the readership of th is journal of complementary and alternative medicine. The survey popul ation was 46% male and 43% female; 11% did not specify gender. They ra nged in age from under 31 years old to over 70. The largest group (37% ) of respondents held degrees as medical doctors, 27% held doctorates in complementary and alternative medicine related disciplines, 11% had registered nursing degrees, 4% were acupuncturists and 18% did not sp ecify their training. Practice characteristics between MD and non-MD a sthma care providers did not differ. The majority had general practice s (75%) seeing all ages of patients. MDs were less likely to employ co mplementary and alternative medicine techniques for asthma compared to non-MDs. Both groups identified dietary and nutritional approaches as their most prevalent and useful asthma treatment option. Use of botan icals, meditation and homeopathy were frequently cited; statistically significant differences appeared in the rankings of treatment usefulne ss and prevalence between MD and non-MDs. Non-MD asthma care providers were more likely to ask patients about their use of complementary and alternative treatments for asthma than MDs (92% vs. 70%), while both groups showed statistically significant increases in their levels of p atient inquiries compared to 2 years previously (up 9% and 8% for MDs and non-MDs respectively). The predominance of diet and nutrition supp lementation used by MDs and non-MDs suggests that further attention an d research efforts should be directed toward this area of complementar y and alternative practice. Other complementary and alternative medici ne practices such as botanicals, meditation and homeopathy appear to w arrant research efforts. Differences between MDs and non-MDs in their use of such therapies may reflect different philosophies as well as tr aining.