Asthma is a chronic disease characterised by the presence of widespread, variable airflow obstruction and accompanied by respiratory symptoms. An important aim of treatment is to improve quality of life by ameliorating the severity of symptoms both on a day-to-day basis and during severe exacerbations. In part, this is achieved by treating these episodes when they arise. However, it is most effectively achieved by preventing the onset of symptoms, and of severe exacerbations, and this can be achieved with good control of the underlying disease abnormality.

Symptoms arise in people with asthma due to airway narrowing. Hence, prevention and reversal of airway narrowing are also important aims of therapy. Asthma may have long-term adverse consequences including premature, irreversible loss of lung function and premature death. The prevention of these outcomes is an important aim of treatment. Effective management of people with asthma entails achieving these aims with the minimum amount of medications. The level of treatment required to achieve good asthma control is another indicator of the severity of the disease or of the effect of alternative management strategies.

The maintenance of quality of life through effective management is also a key aim of treatment. For the person with asthma, the goal is to improve and then maintain the capacity to perform everyday activities – to not be limited by asthma.

The National Asthma Council’s Asthma Management Handbook 2002 (available at www.nationalasthma.org.au) makes recommendations for the assessment and management of asthma in order to achieve these aims. This is a useful resource recommended for all health professionals caring for people with asthma.

In considering the role of complementary therapies in the management of asthma, and in advising patients about their possible use, it is the responsibility of the health professional to be aware of the impact of treatment on both short-term and long-term outcomes of the illness. For example, evidence of short-term efficacy for relief of symptoms or reversal of bronchoconstriction may not be sufficient for recommending a therapy for people with asthma, as there is evidence that long-term undertreatment of asthma can lead to long-term adverse health effects.

In this review, the effects of complementary therapies are summarised in terms of their effects on the following clinically relevant outcomes of asthma:

• symptoms and quality of life
• lung function
• medication requirement.

Exacerbations, premature death and loss of lung function are seldom measured in clinical trials of complementary therapies and are not considered in this review.

Content Updated March 2005