ASSOCIATION BETWEEN COMPLEMENTARY ALTERNATIVE MEDICINE USE AND EMERGENCY DEPARTMENT VISITS FOR ASTHMA EXACERBATION ACROSS THE AMERICAN POPULATION AND AMONG RACIAL MINORITY GROUPS

Abstract

SESSION TITLE: Asthma and Comorbid Disease SESSION TYPE: Original Investigations PRESENTED ON: 10/10/2018 08:45 AM - 09:45 AM PURPOSE: The prevalence and severity of asthma are greater in racial/ethnic minority groups compared to non-Hispanic Whites. The use of Complementary Alternative Medicine (CAM) has been increasing across the American population and is common in asthma treatment. Here, we examine the relationship between CAM use (acupuncture, herbals, homeopathy, massage, and yoga) and asthma exacerbations across the general population as well as among different racial/ethnic groups. METHODS: We analyzed the 2012 National Health Interview Survey (NHIS) limiting to survey respondents > age 18. The primary outcome variable was emergency department (ED) visit within the past year for asthma exacerbation. We performed descriptive analysis on ED visits for asthma exacerbation and CAM use. We then applied multivariable logistic regression to examine the association between CAM use and ED visits for asthma exacerbations both across all participants with asthma and among different racial/ethnic groups, adjusting for age, gender, and having a healthcare provider. RESULTS: The NHIS study sample included 34,525 adults (66.5% Whites, 11.5% Blacks, 14.9% Hispanics, 5.2% Asians, and 2.0% Others). Of this cohort, 4,387 (12.7%) reported having asthma (69.0% Whites, 13.4% Blacks, 11.8% Hispanics, 3.0% Asians, and 2.8% others). Among participants with asthma, higher percentages of Blacks and Hispanics had ED visits for asthma exacerbation compared to Whites (Blacks=16.0%, Hispanics=10.2%, Whites=6.1%). White asthmatics were more likely to use CAM compared to Black and Hispanic asthmatics (Whites=40.2%, Blacks=23.7%, Hispanics=31.6%). Adjusting for age, gender, and having a healthcare provider, CAM use in asthmatic patients was associated with decreased odds (OR=0.59 [0.43-0.83]) of having an ED visit for asthma exacerbation. Among Hispanics with asthma, herbal use in particular (OR=0.20 [0.09-0.44]) was associated with decreased odds of having an ED visit for asthma exacerbation. CONCLUSIONS: There were differences in asthma control and CAM use among different racial/ethnic groups. Blacks and Hispanics were more likely to have an ED visit for asthma exacerbation and were less likely to use CAM. However, CAM use was associated with decreased ED visits for asthma exacerbation among all patients with asthma. Among Hispanic patients, herbal use was significantly associated with decreased ED visits for asthma exacerbation. CLINICAL IMPLICATIONS: This is the first study to suggest an association between CAM use and decreased ED visits for asthma exacerbation as well as to suggest that CAM use is greater in White asthmatics compared to racial/ethnic minorities. While a component of the decreased hospitalizations associated with CAM use may be due to sociodemographic characteristics, it may also reflect other important psychosocial drivers of asthma control which if elucidated may improve medication adherence and healthcare resource utilization. DISCLOSURES: No relevant relationships by Joseph Conigliaro, source=Web Response No relevant relationships by Negin Hajizadeh, source=Web Response No relevant relationships by Sonia Jacome, source=Web Response No relevant relationships by Eun Ji Kim, source=Web Response No relevant relationships by Joseph Simonson, source=Web Response