Ward Claire E, Baptist Alan P
a Division of Allergy and Clinical Immunology , Department of Internal Medicine, University of Michigan Health System , Ann Arbor , MI , USA.
J Asthma. 2016 Jun;53(5):546-52. doi: 10.3109/02770903.2015.1116090. Epub 2016 Jan 19.
A growing number of asthma patients are using Complementary and Alternative Medicine (CAM). Prior studies have not examined CAM use among the older adult population.
Data from the 2011 Behavioral Risk Factor Surveillance Survey (BRFSS), a national telephone survey, and the Asthma Call-Back survey (ACBS), a survey conducted among BRFSS individuals reporting asthma, were used for the analyses. The study population consisted of 7685 individuals aged 55 years or older with current asthma. The relationship of CAM use with demographic and asthma outcomes was analyzed using logistic regression.
CAM use was reported by 39% (3030). Breathing techniques were the most commonly reported CAM therapy. Demographic factors associated with CAM use include female gender (OR 1.36, p < 0.002), having at least a college education (OR 1.76, p < 0.001), cost barrier to healthcare (OR 1.43, p < 0.001), and living in the West (OR 1.31, p < 0.01). An inverse relationship was noted between income and CAM use. Those who had received an asthma action plan (OR 1.29, p < 0.005), current smokers (OR 1.35, p < 0.02), or impaired asthma control (as defined by symptoms affecting sleep, symptoms limiting activities, and rescue medication use) were more likely to use CAM (OR 1.37, p < 0.001; OR 1.38, p < 0.001; and OR 1.2, p < 0.046, respectively).
A large proportion of asthmatic older adults use CAM. In addition, older adults with asthma who use CAM have decreased asthma control, and further studies are needed to determine a causal role.
越来越多的哮喘患者正在使用补充和替代医学(CAM)。先前的研究尚未调查老年人群中CAM的使用情况。
分析来自2011年行为危险因素监测调查(BRFSS,一项全国性电话调查)以及哮喘回访调查(ACBS,对BRFSS中报告患有哮喘的个体进行的调查)的数据。研究人群包括7685名年龄在55岁及以上的现患哮喘患者。使用逻辑回归分析CAM使用与人口统计学和哮喘结局之间的关系。
39%(3030人)报告使用了CAM。呼吸技巧是最常报告的CAM疗法。与CAM使用相关的人口统计学因素包括女性(比值比[OR]1.36,p<0.002)、至少拥有大学学历(OR 1.76,p<0.001)、医疗保健费用障碍(OR 1.43,p<0.001)以及居住在西部(OR 1.31,p<0.01)。收入与CAM使用之间存在负相关关系。那些已收到哮喘行动计划的患者(OR 1.29,p<0.005)、当前吸烟者(OR 1.35,p<0.02)或哮喘控制不佳(根据影响睡眠的症状、限制活动的症状和使用急救药物来定义)的患者更有可能使用CAM(分别为OR 1.37,p<0.001;OR 1.38,p<0.001;以及OR 1.2,p<0.046)。
很大一部分老年哮喘患者使用CAM。此外,使用CAM的老年哮喘患者哮喘控制情况较差,需要进一步研究以确定其因果关系。