An integrative medicine approach to asthma: who responds?
OBJECTIVE
The objectives of this study were to develop a better understanding of which patients with chronic illness tend to respond to integrative medicine interventions, by identifying a set of characteristics or qualities that are associated with a positive outcome in a randomized clinical trial of an integrative medicine approach to asthma that incorporated journaling, yoga breathing instruction, and nutritional manipulation and supplementation.


METHODS
The study used qualitative analysis using a grounded-theory approach comparing a group of responders in the parent trial (based on the Asthma Quality of Life Scale) to a group of nonresponders.


RESULTS
Twelve (12) responders and 8 nonresponders were interviewed. Responders demonstrated an attitude of "change as challenge;" a view of themselves as "independent" and "leaders;" an ability to accept one's illness while still maintaining a feeling of control over one's choices; a connection to the deeper context or meaning of complementary and alternative medicine (CAM) interventions, as opposed to just "previous experience" of CAM; and a sense of determination, commitment, and "willingness to fight" for what one needs from the health care system. Nonresponders were more often uncertain and anxious in their relationship to their asthma, tending to fall back on denial, and lacking a connection to the deeper context or philosophy of CAM interventions.


CONCLUSIONS
It is possible to identify a set of characteristics that may predict a positive response to an integrative/lifestyle approach to asthma. These characteristics should be examined prospectively using both quantitative and qualitative methods in future integrative medicine clinical trials.
Beth Israel Medical Center, New York, NY, USA. bkligler@chpnet.org
Benjamin
B
Kligler
Melissa Diane
MD
McKee
Esther
E
Sackett
Hanniel
H
Levenson
Jeanne
J
Kenney
Alison
A
Karasz
D000203:Activities of Daily Living; D001007:Anxiety; D001249:Asthma / Q000628:therapy*; D001294:Attitude to Health; D001945:Breathing Exercises; D000529:Complementary Therapies; D003717:Denial, Psychological; D005260:Female; D006801:Humans; D055048:Integrative Medicine; D007407:Interviews as Topic; D007857:Leadership; D008297:Male; D019122:Meditation; D044623:Nutrition Therapy; D010684:Philosophy; D036301:Qualitative Research; D011788:Quality of Life; D020377:Self Efficacy; D016896:Treatment Outcome; D015013:Yoga