Update on the Utilization of Complementary Therapies by Adolescents with Asthma in an Urban Population

To assess the prevalence and perceived efficacy of complementary and alternative medicine (CAM) use among urban adolescents with asthma, building on a previous landmark study, and to determine if CAM use varied by asthma severity, asthma control test (ACT), and non-CAM prescriptions for asthma treatment. An adapted survey was completed by 203 patients aged 13-18 years in outpatient specialty and primary care clinics in the Bronx, NY. Demographic information, adherence to prescription(s), ACT, and past year CAM utilization, perceived efficacy of CAM used, and substitution for prescription were assessed via self-report while severity, and related active prescriptions were derived through electronic health records. We conducted logistic regressions to determine if CAM use (yes/no) was associated with ACT (controlled/uncontrolled) or severity (persistent/intermittent). 82% of participants utilized at least one form of CAM in the management of their asthma. Mind-body (65%) and natural products (63%) were the most frequent with highest reported perceived efficacy (81%). Only 35% of patients discussed CAM use with their provider. ACT did not vary by CAM use (AOR: 1.57; 95%CI: 0.59, 4.15; p = 0.37), while prescription adherence was associated with a nearly seven-fold increase in CAM use (AOR: 7.79; 95%CI: 3.27, 18.54; p<.0001). The prevalence of CAM use amongst Bronx adolescents with asthma has likely largely remained stable since an initial 2002 analysis. Despite a lack of association between CAM use and asthma control, there was a high degree of perceived efficacy. Adolescents who use CAM for asthma management may do so as an overall component of health-promoting behavior such as prescription adherence.