Original ArticleDon't Ask, Don't Tell: Parental Nondisclosure of Complementary and Alternative Medicine and Over-the-Counter Medication Use in Children's Asthma Management
Section snippets
Design
The data for these secondary analyses were derived from a study investigating the impact of parental beliefs about the nature of asthma and its treatment on the adequacy of the child's treatment regimen. The study was cross-sectional and used a one-time, semi-structured home interview of parents of children with asthma and the children themselves, and a retrospective 1-year review of the children's medical records. An additional section on CAM use was added to the parent interview as part of
Analytic Strategies
Descriptive statistics summarize nondisclosure of OTC medications and CAM use and subgroup differences by type of therapy, race, poverty, education, and symptom severity. Chi-square analyses were conducted to examine differences in nondisclosure by type of CAM/OTC medication and also the sociodemographic differences for reasons for nondisclosure.
Multinomial logistic regression analysis using maximum likelihood estimation (SAS version 9.1) examined the influence of the parent-HCP relationship on
Descriptive Statistics of Sample and CAM/OTC Use
Three parents who reported “Other” race were excluded from all analyses because the group was too small and diverse to make meaningful race-related comparisons. Table 1 shows the descriptive statistics for the sample (N = 225).
Overall, 159 of 225 parents (71%) reported ever using CAM and/or OTC therapies to manage their child's asthma. There were statistically significant differences based on race, education, poverty, and child's symptom severity between those parents who reported using CAM/OTC
Discussion
This study provides the first in-depth exploration of parental nondisclosure to HCPs of CAM and OTC medication use in pediatric asthma management. The results demonstrated that 54% of parents who used CAM and OTC medications to manage their children's asthma symptoms were not disclosing their use to their HCP. Full disclosure occurred only one third of the time, regardless of race, education, or poverty.
The reasons parents gave for nondisclosure in this study parallel what has been reported in
Study Limitations
Several limitations to this study need to be discussed. Our sample included only 17 Hispanic families, which resulted in low study power for the analyses examining racial differences in disclosure and nondisclosure. Recall bias may have been a factor because we asked parents to report on CAM and OTC medications ever used to treat their child's asthma. We thus focused on lifetime use of these therapies because the disclosure and barriers to disclosure questions were for lifetime (“ever used”).
Kimberly Sidora-Arcoleo is Assistant Professor, Arizona State University College of Nursing & Healthcare Innovation, Phoenix, Ariz.
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Cited by (0)
Kimberly Sidora-Arcoleo is Assistant Professor, Arizona State University College of Nursing & Healthcare Innovation, Phoenix, Ariz.
H. Lorrie Yoos is Professor, University of Rochester School of Nursing and Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Harriet Kitzman is Professor, University of Rochester School of Nursing and Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, NY.
Ann McMullen is Associate Professor of Clinical Nursing, University of Rochester School of Nursing, Rochester, NY.
Elizabeth Anson is Senior Information Analyst, University of Rochester School of Nursing, Rochester, NY.
This research was funded by National Institute for Nursing Research grant No. 1RO1NR007905-01A2.