The use of complementary and alternative medicines (CAM) is common among people with severe asthma who come from low-income ethnic minorities, US researchers have found.

Furthermore, the findings, published in the Journal of General Internal Medicine, indicate that many such patients do not inform their doctors about their use of CAM, therefore significantly increasing their risk of harmful drug interactions and allergies that could cause fatal asthma attacks.

For their study, Dr Maureen George, from Johns Hopkins University School of Nursing in Baltimore, Maryland, and colleagues interviewed 26 women and two men, aged between 21 and 48 years, who had severe asthma and identified themselves as African Americans of low income from inner city areas.

People with a low income from ethnic minorities in the USA are known to have a higher risk of death and disability due to asthma than Caucasians from more affluent backgrounds.

Results of the interviews revealed that all the participants used some form of CAM in combination with conventional medicine. Many interviewees used CAM as an addition to or substitute for conventional care because they thought it was "more natural", could reduce the need for conventional drugs such as steroids and offered some hope of a cure.

Although all the participants said they did not replace prescription medication with CAM, 63% reported they had not stuck to their conventional therapy in the 2 weeks prior to the interviews or that they had missed doses.

The researchers also found that many participants did not disclose their use of CAM to their healthcare providers.

The team emphasises that this could lead to an increased risk of conventional drug/CAM interactions and unnecessary delays in seeking appropriate medical attention. Furthermore, some patients were taking herbs and remedies that could result in asthma attacks due to allergic reactions.

"While most subjects trusted prescription asthma medicine, there was a preference for integration of CAM with conventional asthma treatment. CAM was considered natural, effective and potentially curative," Dr George summarised.

The researchers conclude that doctors should be aware of CAM use among low-income minority patients with severe asthma and add "discussing patients' desire for an integrated approach to asthma management and involving social networks are two strategies that may enhance patient-provider partnerships and treatment fidelity".