Herbal Remedy Users Have Worse Asthma

Inner-city asthma sufferers who take herbal remedies tend to have worse symptoms and to use their inhalers less, researchers find.

Do these patients rely too much on unproven herbal remedies? Or are they turning to alternative treatments because they aren't getting enough relief from their medications?

That's not yet clear. What is clear is that doctors treating asthma patients should ask about their use of herbal remedies -- particularly if their asthma isn't under control.

"Although complementary/alternative medicine may be acceptable for some patients with preferences for using these products, it needs to be used in conjunction with prescribed [inhalers]," note researchers Angkana Roy, MD, of New York's Mount Sinai School of Medicine, and colleagues.

A recent study found that as many as four in five adults with asthma report having used complementary or alternative medicines. Roy and colleagues wondered whether patients were using these products in place of inhalers, which are considered essential to asthma control.

To explore the issue, the researchers surveyed patients with persistent asthma being treated at outpatient clinics in East Harlem, New York City; and in New Brunswick, N.J.

They asked 326 adult patients, "Sometimes people use home remedies, such as teas, rubs, and herbs for asthma. In the past six months, have you used any of these remedies?"

They also rated how well patients had their asthma under control and gave them questionnaires on their knowledge and beliefs about asthma.

They found that the 25% of patients who used herbal remedies were actually better informed about the lung inflammation at the heart of asthma than those who did not use the remedies. Herb users were more likely to be worried about the side effects of their inhalers, and had more trouble following their medication schedule.

That last finding, Roy and colleagues say, may suggest a reason why herbal remedy users used their inhalers less than they were supposed to. It could explain why they had worse disease than those who did not use the remedies.

On the other hand, they note, "Increased severity of illness may lead patients to use herbal remedies as a last resort when conventional therapy is not working."

Whether or not either of these explanations is true, the researchers advise health care workers to have a non-judgmental conversation about strategies to improve patients' asthma control.

The Roy study appears in the February issue of Annals of Allergy, Asthma & Immunology.