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Ramdzan SN, Pinnock H, Liew SM, Sukri N, Salim H, Hanafi NS, Hussein N, Suhaimi J, Lee PY, Cheong AT, Ahad AM, Cunningham S, Khoo EM. Perceptions of complementary/alternative medicine use and influence on evidence-based asthma medicine adherence in Malaysian children. NPJ Prim Care Respir Med 2019; 29:5. [PMID: 30804340 PMCID: PMC6389881 DOI: 10.1038/s41533-019-0118-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Accepted: 01/29/2019] [Indexed: 02/06/2023] Open
Abstract
Complementary and alternative medicine (CAM) is widely used especially in Asia including for childhood asthma. The use of CAM could influence adherence to evidence-based (E-B) medicine. We explored the views of carers of Malaysian children with asthma regarding the use of CAM for childhood asthma, and its relationship with self-reported adherence to E-B medicine. We used a screening questionnaire to identify children diagnosed with asthma from seven suburban primary schools in Malaysia. Informed consent was obtained prior to the interviews. We conducted the interviews using a semi-structured topic guide in participants' preferred language (Malay, Mandarin, or Tamil). All interviews were audio-recorded, transcribed verbatim and coded using Nvivo. Analysis was performed thematically, informed by the Necessity-Concerns Framework. A total of 46 carers (16 Malays, 21 Indians, 9 Chinese) contributed to 12 focus groups and one individual interview. We categorised participants' as 'Non-CAM'; 'CAM'; or 'combination' user. Cultural practices and beliefs in the efficacy of CAM resulted in widespread use of CAM. Most carers used CAM as 'complementary' to E-B medicine. Concerns about dependence on or side effects of E-B treatment influenced carers' decisions to rely on CAM as an 'alternative', with an important minority of accounts describing potentially harmful CAM-use. Healthcare professionals should discuss beliefs about the necessity for and concerns about use of both E-B medicine and CAM, and provide balanced information about effectiveness and safety. The aim is to improve adherence to regular E-B preventer medication and prevent delays in seeking medical advice and harmful practices associated with CAM.
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Affiliation(s)
- Siti Nurkamilla Ramdzan
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. .,NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Su May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Nursyuhada Sukri
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hani Salim
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Universiti Putra Malaysia, Selangor, Malaysia
| | - Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Julia Suhaimi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | | | - Steve Cunningham
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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