title: Use of herbal products, coffee or black tea, and over-the-counter medications as self-treatments among adults with asthma.
abstract: BACKGROUND
  There are few data on the use of alternative therapies in adult asthma and their impact on health outcomes.
  
  
  OBJECTIVE
  The objective of this study was to study the prevalence and morbidity of asthma self-treatment with herbs, coffee or black tea, and over-the-counter (OTC) medications containing ephedrine or epinephrine.
  
  
  METHODS
  We carried out a cross-sectional analysis of interview data for 601 adults with asthma recruited from a random sample of pulmonary and allergy specialists. We estimated the 12-month prevalence of reported use of herbal products, coffee or black tea, or OTC products to self-treat asthma and their association with emergency department visits and hospitalization.
  
  
  RESULTS
  Herbal asthma self-treatment was reported by 46 (8%; 95% confidence interval [CI] 6% to 10%); coffee or black tea self-treatment by 36 (6%; 95% CI 4% to 8%), epinephrine or ephedrine OTC use by 36 (6%; 95% CI 4% to 8%), and any of the three practices by 98 subjects (16%; 95% CI 13% to 19%). Adjusting for demographic and illness covariates, herbal use (odds ratio [OR] 2.5; 95% CI 1.1 to 5.6) and coffee or black tea use (OR 3.1; 95% CI 1.2 to 7.8) were associated with asthma hospitalization; OTC use was not (OR 0.8; 95% CI 0.3 to 2.5).
  
  
  CONCLUSIONS
  Even among adults with access to specialty care for asthma, self-treatment with nonprescription products was common and was associated with increased risk of reported hospitalization. This association does not appear to be accounted for by illness severity or other disease covariates. It may reflect delay in utilization of more efficacious treatments.
authors.affiliation: Department of Medicine, University of California San Francisco, 94143-0924, USA.
authors.forename: P D
authors.initials: PD
authors.lastname: Blanc
authors.forename: W G
authors.initials: WG
authors.lastname: Kuschner
authors.forename: P P
authors.initials: PP
authors.lastname: Katz
authors.forename: S
authors.initials: S
authors.lastname: Smith
authors.forename: E H
authors.initials: EH
authors.lastname: Yelin
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D003069:Coffee / Q000627:therapeutic use*; D000529:Complementary Therapies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D004366:Nonprescription Drugs / Q000627:therapeutic use*; D008517:Phytotherapy; D010946:Plants, Medicinal / Q000627:therapeutic use*; D011897:Random Allocation; D012651:Self Medication; D013147:Spirometry; D013662:Tea / Q000627:therapeutic use*
chemical_list: D003069:Coffee; D004366:Nonprescription Drugs; D013662:Tea