title: Complementary and alternative medicine use and adherence with pediatric asthma treatment.
abstract: OBJECTIVE
  Complementary and alternative medicine (CAM) use for pediatric asthma is increasing. The authors of previous studies linked CAM use with decreased adherence to conventional asthma medicines; however, these studies were limited by cross-sectional design. Our objective was to assess the effect of starting CAM on pediatric adherence with daily asthma medications.
  
  
  METHODS
  We used a retrospective cohort study design. Telephone surveys were administered to caregivers of patients with asthma annually from 2004 to 2007. Dependent variables were percent missed doses per week and a previously validated "Medication Adherence Scale score." Independent variables included demographic factors, caregiver perception of asthma control, and initiation of CAM for asthma. We used multivariate linear regression to assess the relationship between medication adherence and previous initiation of CAM.
  
  
  RESULTS
  From our longitudinal data set of 1322 patients, we focused on 187 children prescribed daily medications for all 3 years of our study. Patients had high rates of adherence. The mean percent missed asthma daily controller medication doses per week was 7.7% (SD = 14.2%). Medication Adherence Scale scores (range: 4-20, with lower scores reflecting higher adherence) had an overall mean of 7.5 (SD = 2.9). In multivariate analyses, controlling for demographic factors and asthma severity, initiation of CAM use was not associated with subsequent adherence (P > .05).
  
  
  CONCLUSIONS
  The data from this study suggest that CAM use is not necessarily "competitive" with conventional asthma therapies; families may incorporate different health belief systems simultaneously in their asthma management. As CAM use becomes more prevalent, it is important for physicians to ask about CAM use in a nonjudgmental fashion.
authors.affiliation: Department of Dermatology, University of California, San Francisco School of Medicine, San Francisco, California, USA. philpj@derm.ucsf.edu
authors.forename: Julie C
authors.initials: JC
authors.lastname: Philp
authors.forename: Judy
authors.initials: J
authors.lastname: Maselli
authors.forename: Lee M
authors.initials: LM
authors.lastname: Pachter
authors.forename: Michael D
authors.initials: MD
authors.lastname: Cabana
mesh_terms: D000293:Adolescent; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000529:Complementary Therapies / Q000706:statistics & numerical data*; D017723:Drug Utilization Review; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008824:Michigan; D012189:Retrospective Studies; D013223:Statistics as Topic; D016903:Drug Monitoring
chemical_list: D018927:Anti-Asthmatic Agents