Air Pollution and Respiratory Health Branch, Division of Environmental Hazards and Health Effects, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Prev Med. 2012 Jan;54(1):27-31. doi: 10.1016/j.ypmed.2011.10.007. Epub 2011 Oct 15.
To estimate the prevalence of complementary and alternative medicine (CAM) use among children with current asthma.
We analyzed data from the Asthma Call Back Survey (ACBS) 2006-2008. ACBS is a follow-up to the state-based Behavioral Risk Factor Surveillance System (BRFSS) survey that collects information on asthma and related factors including CAM use for asthma. The survey is administered to the parents who report in a subset of BRFSS states that their children have asthma. 5435 children had current asthma and were included in this analysis.
Overall, 26.7% (95% confidence interval [CI]=24.5-29.0) of children with current asthma reported CAM use in the previous 12 months. Among them, the three most commonly used therapies were breathing techniques (58.5%; 95% CI=53.6-63.5), vitamins (27.3%; 95% CI=23.0-31.5), and herbal products (12.8%; 95% CI=9.2-16.4). Multivariate analysis of CAM use revealed higher adjusted odds ratios (aOR) among children who experienced cost barriers to conventional health care compared with children with no cost barrier (aOR=1.8; 95% CI=1.2-2.8). Children with poorly controlled asthma were most likely to use all types of CAM when compared to their counterpart with well-controlled asthma: aOR=2.3 (95% CI=1.6-3.3) for any CAM; aOR=1.7 (95% CI=1.2-2.6) for self-care based CAM; and aOR=4.4 (95% CI=1.6-9.3) for practitioner-based CAM.
Children with poorly controlled asthma are more likely to use CAM; this likelihood persists after controlling for other factors (including parent's education, barriers to conventional health care, and controller medication use). CAM is also more commonly used by children who experienced cost barriers to conventional asthma care. CAM use could be a marker to identify patients who need patient/family education and support thus facilitate improved asthma control.
评估当前患有哮喘的儿童中补充和替代医学(CAM)的使用情况。
我们分析了 2006-2008 年哮喘随访调查(ACBS)的数据。ACBS 是基于州的行为危险因素监测系统(BRFSS)调查的后续调查,该调查收集了有关哮喘和相关因素的信息,包括哮喘的 CAM 使用情况。该调查针对报告其子女患有哮喘的 BRFSS 州的一部分父母进行管理。共有 5435 名患有当前哮喘的儿童纳入本分析。
总体而言,26.7%(95%置信区间[CI]=24.5-29.0)的当前哮喘患儿报告在过去 12 个月内使用了 CAM。其中,使用最多的三种疗法是呼吸技术(58.5%;95%CI=53.6-63.5)、维生素(27.3%;95%CI=23.0-31.5)和草药产品(12.8%;95%CI=9.2-16.4)。CAM 使用的多变量分析显示,与无费用障碍的儿童相比,经历常规医疗保健费用障碍的儿童调整后的优势比(aOR)更高(aOR=1.8;95%CI=1.2-2.8)。与哮喘控制良好的患儿相比,哮喘控制不佳的患儿更有可能使用所有类型的 CAM:任何 CAM 的 aOR=2.3(95%CI=1.6-3.3);自我保健 CAM 的 aOR=1.7(95%CI=1.2-2.6);从业者 CAM 的 aOR=4.4(95%CI=1.6-9.3)。
哮喘控制不佳的儿童更有可能使用 CAM;在控制其他因素(包括父母的教育程度、常规医疗保健障碍和控制器药物使用情况)后,这种可能性仍然存在。CAM 也更常用于经历常规哮喘治疗费用障碍的儿童。CAM 的使用可能是识别需要患者/家庭教育和支持以促进改善哮喘控制的患者的标志。