Analysis of the evidence profile of the effectiveness of complementary therapies in asthma: A qualitative survey and systematic review

A qualitative study of the views of patient representatives, researchers, doctors and complementary practitioners followed by a systematic review of randomized trials of complementary therapy interventions in asthma found numerous points of disparity between what is sought from research on complementary medicine in asthma and what has been published.

Abstract

Objectives: To provide information necessary for the strategic planning of research on the effectiveness of complementary therapies in asthma. Design: A qualitative study of the views of patient representatives, researchers, doctors and complementary practitioners followed by a systematic review of randomized trials of complementary therapy interventions in asthma. Main outcome measures: Qualitative study: views on research priorities in complementary medicine and asthma; Systematic review: intervention, number of treatments, number of patients, control group, blinding, length of follow-up, patients and outcome measures. Results: Qualitative study: randomized trials were seen as essential; there was disagreement about the role of placebos with some respondents wanting to know whether particular therapies had specific effects whilst others sought information about the overall effects of a treatment; there was support for trials where interventions are examined as they are practised; it was thought that outcome assessment needed to be long-term. Systematic review: Thirty-five papers were included in the review, 29 of which examined either acupuncture of self-regulation techniques such as yoga or relaxation. With the exception of the latter, most studies were small, short-term, placebo-controlled, assessed lung function rather than patient-assessed symptoms and investigated a treatment not widely found in clinical practice. Trials on self-regulation techniques tended to be larger, involved longer-term follow-up and investigated the techniques normally used by practitioners. Conclusions: There are numerous points of disparity between what is sought from research on complementary medicine in asthma and what has been published. Future research should be problem-led.