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Background and objective: Metformin is a first-line treatment for patients with diabetes. Recent animal studies indicated that metformin can reduce airway inflammation. However, it remains unclear whether the use of metformin can help patients maintain asthma control. The purpose of this study was to evaluate the association between the use of metformin and asthmarelated outcomes, which include asthma-related hospitalization, asthma-related emergency room visits and asthma exacerbation, among patients with concurrent asthma and diabetes. Methods: We conducted an 11-year (2001-2011) retrospective cohort study using the Taiwan National Health Insurance Research Database. Patients with concurrent asthma and diabetes were included. The date of the first observed prescription of metformin was defined as the index date. For each metformin user, two matched metformin non-users of the same age and gender were randomly selected. Patients were followed for 3 years to measure the occurrence of asthma-related outcomes. Multivariable logistic regression models were used to assess the association between metformin use and asthma-related outcomes. Results: Of 1332 patients with concurrent asthma and diabetes, 444 (33.3%) were metformin users. Compared with non-users, metformin users had a lower risk of asthma-related hospitalization (OR = 0.21, 95% CI: 0.07-0.63) and asthma exacerbation (OR = 0.39, 95% CI: 0.19-0.79). Conclusion: The risk of asthma-related outcomes was lower for metformin users than non-users. Health-care providers should consider metformin as a treatment strategy for patients with concurrent asthma and diabetes.

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Analyses of 2002 National Health Interview supplement on complementary and alternative medicine (NHI%AM) indicate that approximately 38 million adults in the US (18.9% of the population) used natural herbs or supplements in the preceding 12 months, but only one-third told their physician about this use. The objectives of this study are: (i) to determine subpopulation rates of patient–physician communication about herbal product and natural supplement use and (ii) to identify the relative influence of patient factors and interaction factors associated with patient-physician communication about herb and supplement use. Logistic secondary analysis was done by using the complementary and alternative medicine supplement of the 2002 National Health Interview Survey. Subjects were a random stratified sample of US adults who used herbs in the past 12 months (n = 5 196) and self-reported rates of disclosure to physicians about herb and supplement use. Results show that disclosure rates were significantly lower for males, younger adults, racial and ethnic minorities and less intensive users of medical care. Across subpopulations, disclosure was the exception rather than the norm. Given the potential risks of delayed or inappropriate treatment and adverse drug reactions and interactions, physicians should be aware of herb and supplement use and counsel patients on the potential risks and benefits of these treatments.

Background. In 1990s, complementary and alternative medicine (CAM), including use of herbs and supplements, gained popularity in the United States. However, more recent surveys suggest that demand for herbs and supplements has stabilized. Objective. This study examined the prevalence, patterns, and changes in herb and supplement use among the US adults, using the 2002, 2007, and 2012 National Health Interview Surveys (NHIS). Methods. Weighted population estimates were derived from three complementary and alternative medicine supplements to the NHIS. Prevalence rates for herb and supplement use were compared, using Wald chi-square tests to measure changes between years. Results. An estimated 40.6 million US adults reported herb and supplement use in 2012. However, the rate of herb and supplement use dropped from 18.9% in 2002 to 17.9% in 2007 and 2012 (P < 0.05). This decline in use was more pronounced among women, racial or ethnic minorities, and adults with low incomes. Conclusion. Herb and supplements use remains common in the USA, but adult use rates are on the decline. It is still important for health care providers to ask patients about herb and supplement use.