title: Contesting asthma medication: patients' view of alternatives.
abstract: BACKGROUND
  There are few studies pertaining to asthma patients' views on complementary and alternative medicine (CAM). The driving question behind the study is why some asthma patients choose noncompliance to conventional western medicine and resort to other modalities, often deemed as being 'alternative,' 'complementary,' or 'integrated.' Does the patients' emancipation movement lead to greater awareness of the benefits of alternative medicine? Does the patients' identity as asthma sufferers play a role in their decision?
  
  
  METHODS
  Case studies based on semistructured interviews were conducted between June 2009 and January 2010 with 19 asthma patients in The Netherlands who have chosen complementary and alternative medicine (CAM). Patients were contacted through online forum of Dutch asthma patients' organization Astma Fonds.
  
  
  CONCLUSIONS
  We have discovered that on the whole patients in the present study were well informed about risks and benefits of both prescribed and alternative medicines. We have argued that noncompliance to medical regime by some asthma patients can be explained by the rationality of their choice based on evidence of clinical trials of commonly assigned asthma medication as well as partial and anecdotal evidence of the benefits of CAM therapies. It is the patients themselves who, by invoking the same evidence-based dominant paradigm choose to address the conflict between protagonists of 'conventional,' western medicine and other modalities.
  
  
  CONCLUSIONS
  The author argues that asthma patients' noncompliance with (Western) medical regime and choice for alternative medical treatment of asthma is a matter of rational choice informed by evidence-based awareness. This evidence-based rationality particularly refers here to the patients' awareness of the rather controversial results of clinical trials of commonly used asthma medicines, particularly those containing elements of budesonide (Pulmicort), an anti-inflammatory corticosteroid, and formoterol (Oxis, Foradil), a rapid-acting and long-lasting beta(2)-agonist (bronchodilator).
authors.affiliation: Institute of Advanced Labour Studies, University of Amsterdam, Amsterdam, The Netherlands. h.kopnina@uva.nl
authors.forename: Helen
authors.initials: H
authors.lastname: Kopnina
mesh_terms: D000328:Adult; D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy / Q000523:psychology / Q000628:therapy*; D000529:Complementary Therapies / Q000523:psychology / Q000592:standards*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology*; D010349:Patient Compliance / Q000523:psychology; D010361:Patients
chemical_list: D018927:Anti-Asthmatic Agents