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SUMMARY OF PRACTICE POINTS
| LEVEL OF EVIDENCE |
| Ask about use of complementary medicines and advise patients about potential hazards. |
[√] |
| Warn patients that echinacea and royal jelly can precipitate life-threatening anaphylaxis in predisposed individuals with asthma |
IV |
| Encourage patients to choose TGA-assessed products in preference to unregulated products and make sure they understand that the Aust L code does not indicate that the product is effective. |
[√] |
| Monitor effects of complementary therapies as for conventional therapies. |
[√] |
| There is evidence for subjective improvements in asthma symptoms with some breathing techniques, but not for improvement in lung function. |
I |
| Current evidence does not support the use of manual therapies (chiropractic, osteopathy and related modalities) for patients with asthma. |
I |
| Current evidence does not support the use of acupuncture as a treatment for asthma. |
I |
| Physical training improves cardiopulmonary fitness but does not improve lung function or symptoms. |
I |
| Based on current evidence, health professionals can advise patients that homeopathy is ineffective. |
I |
| Although some traditional Chinese medicines might be beneficial in asthma, they cannot yet be recommended for clinical use based on current efficacy and safety data. |
I |
| Alternative diagnostic tests should not be used in the diagnosis of asthma and allergies. |
[√] |
| Note: various definitions of ‘complementary' and ‘alternative' medicine are used in Australia and overseas. Here CAM refers to the wide range of medical and health care systems, practices and products that are not currently considered to be part of conventional medicine.1
Since this is a large and growing field, an exhaustive review of evidence is beyond the scope of this handbook.
For more information on CAM and asthma, see Information resources
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Health care professionals treating patients with asthma need to be aware of the widespread use of complementary and alternative medicine (CAM). A recent large Australian survey estimated that 52% of Australians use complementary medicines and 27% consult CAM practitioners. Of those who use complementary medicines, 57% do not report this to their doctor, and 50% use complementary medicines and conventional medicines concurrently.2
Health professionals can increase patients' understanding of expected health effects of complementary medicine through a non-judgemental approach and an honest discussion of what is known about their effects and by avoiding a rigid dismissal of complementary therapy. When treating a patient with asthma:
- always ask about use of complementary products when taking a medication history
- consider potential effects on asthma and interactions between complementary medicines and prescribed conventional asthma medications
- approach the issue of CAM in an open, sympathetic manner, acknowledging the patient's experience with complementary therapies and asthma control
- be aware of potential hazards of CAM and advise patients about these (Table 1).
If introducing complementary therapies, any dose reduction in conventional therapy should be conducted under the supervision of a medical practitioner to avoid adverse outcomes.
Content Created (Thursday, 16 November 2006)
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Last Updated ( Wednesday, 01 August 2007 )
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Complementary medicine 
