Inhaled corticosteroid beliefs, complementary and alternative medicine in children presenting to the emergency department for asthma.
OBJECTIVE
Negative beliefs about inhaled corticosteroids (ICS) and endorsement of complementary and alternative medicine (CAM) have been associated with medication non-adherence and uncontrolled asthma. The association of CAM and negative health beliefs is not described in children in acute care settings. Our study objective is to determine the relationship between negative ICS beliefs, CAM use and poorly controlled asthma among a predominantly Latino population in an acute care setting.


METHODS
The study was conducted in the pediatric emergency department of a children's hospital. During an ED asthma encounter, validated questionnaires surveyed parents about negative ICS beliefs, CAM use, and asthma health and control. We compared asthma health reports between parents who did or did not endorse negative ICS beliefs or CAM use, by chi-squared test (or a Fisher's exact test where appropriate).


RESULTS
Parents of 174 children identified mostly as Latino with Medicaid insurance and high asthma morbidity. CAM endorsement and negative ICS beliefs were both associated with increased use of lifetime glucocorticoid (p = 0.03 and p=0.01 respectively). While CAM endorsement was associated with less hospitalizations (p = 0.04) and parental report of asthma "getting better" (p = 0.01), CAM users reported trouble with paying for rent or food (p = 0.02). Negative ICS beliefs and CAM endorsement were not associated with medication adherence.


CONCLUSIONS
Negative ICS beliefs are associated with higher number of oral glucocorticoid courses. The association between CAM endorsement and asthma control is varied, but mostly in favor of improved control. Financial difficulties may make CAM use more likely.
['Ravandi|Bahareh|B|', 'George|Maureen|M|', 'Thompson|Lindsey|L|', 'Vangala|Sitaram Vangal|SV|0000-0002-8842-5702', 'Chang|Todd|T|', 'Okelo|Sande|S|']
D000280:Administration, Inhalation D000293:Adolescent D000305:Adrenal Cortex Hormones D018927:Anti-Asthmatic Agents D001249:Asthma D002648:Child D002675:Child, Preschool D000529:Complementary Therapies D004636:Emergency Service, Hospital D005260:Female D007722:Health Knowledge, Attitudes, Practice D006776:Hospitals, Pediatric D006801:Humans D008297:Male D010290:Parents D012720:Severity of Illness Index D012959:Socioeconomic Factors D014481:United States
negative health beliefs pediatric medication adherence asthma control