Asthma prevalence, morbidity and mortality are increasing and disproportionate increases have been noted in low-income urban minority patients. Despite excellent pharmacotherapy, adherence to inhaled corticosteroids (ICS), a cornerstone of asthma therapy, remains poor. Evidence now suggests that folk and spiritual healing are widely used in inner city minority patients however, little is known about the specific types of therapies used for asthma and the impact of their use on patient adherence to ICS. The central hypothesis states that urban low-income Black, not Hispanic and Hispanic adults with asthma use folk and spiritual healing and that use affects adherence to prescribed ICS therapy. These therapies may serve as alternatives to prescribed medications because of patients concerns over safety and efficacy of ICS use. Alternatively, patients who are actively engaged in the management of their disease may avail themselves of both complementary and prescribed therapies.
In Aim 1, the researcher will characterize therapies used by urban, low-income Black, not Hispanic and Hispanic adults with asthma using inductive analysis of 50 patient interviews.
In Aim 2, the investigator will determine whether use of alternative therapies impedes or promotes patient adherence to ICS therapy using descriptive and bivariate analysis. The identification of therapies that patients use will likely promote a better appreciation for the array of therapies available to treat asthma in the community and may encourage more open communication between providers and patients.
