FCAAIA Notes: There is so much research regarding the safety of asthma medications and the risks of poorly controlled asthma that it never fails to amaze me that some patients are still more afraid of the treatment than the disease. Similarly, there is little evidence to support the effectiveness of most alternative therapies.  Those that have been proven more effective than placebo have not been proven more effective than FDA approved medications.

Inhaled corticosteroids are the preventative treatment of choice for persistent asthma (defined in part as having asthma symptoms more than twice per week or middle of the night symptoms more than twice per month). This doesn’t mean that other preventive options aren’t available.  Don’t suffer from your asthma!  Come see us for safe and effective control of your disease…you won’t regret feeling better!

(Source: http://www.healio.com/allergy-immunology/asthma-lower-airway-diseases/news/online/%7B92dd21e1-4364-4d04-ba48-5182e3ea9374%7D/uncontrolled-asthma-linked-with-negative-ics-beliefs-in-urban-cohort   September 25, 2014. Adapted from J Allergy Clin Immunol. 2014;doi:10.1016/j.jaci.2014.07.044.)

Uncontrolled asthma was associated with negative beliefs about inhaled corticosteroids and support for complementary and alternative medicines primarily among urban minority adults, according to recent study results.

Maureen George, PhD, RN, FAAN, assistant professor, Department of Family and Community Health, University of Pennsylvania School of Nursing, Philadelphia, and colleagues developed and psychometrically tested “a brief self-administered tool with low literacy demands to identify negative inhaled corticosteroid (ICS) beliefs and complementary and alternative medicine (CAM) endorsement” and evaluated its clinical utility in primary care.

Comprehensive literature reviews and experts were used to identify candidate items for the instrument. It was distributed to 304 adults (mean age, 49.7 years; 77% female; 78% black; 81% with a high school education or less) with persistent asthma in Philadelphia. In a second phase content analysis, audio-recorded visits of 33 adults (mean age, 48.1 years; 97% female; 100% black; 83% with a high school education or less) with persistent asthma and their 10 PCPs (five physicians; five nurse practitioners; 80% female; 80% white) were used to preliminarily evaluate the instrument’s clinical utility for complementary and alternative asthma management.

Seventeen items represented ICS beliefs (Cronbach’s alpha=0.59) and CAM endorsement (a=0.68). Test-retest analysis for reliability was considered high (intraclass correlation coefficient, 0.79 for ICS items; 0.77, CAM items). CAM endorsement (93%), negative ICS beliefs (68%) and uncontrolled asthma (69%) displayed high rates, and uncontrolled asthma was associated with CAM endorsement (P=.04).

“Qualitative data analyses provided preliminary evidence for the instrument’s clinical utility in that knowledge of ICS beliefs and CAM endorsement prompted providers to initiate discussion with patients,” the researchers reported.

“Negative ICS beliefs and CAM endorsement were common and associated with uncontrolled asthma,” the researchers concluded, writing that their self-administered questionnaire “might be a leveraging tool to change the content of communications during clinic visits.”

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