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