SYSTEMATIC REVIEW article

Front. Pharmacol.

Sec. Obstetric and Pediatric Pharmacology

Volume 16 - 2025 | doi: 10.3389/fphar.2025.1621101

Trade-offs from a Family Perspective: Considerations in Choosing Between Omalizumab and Complementary Alternative Medicine for Pediatric Severe Asthma

Provisionally accepted
Hang  CHENHang CHEN1Yan  XuYan Xu1*Jianli  QiuJianli Qiu1Zhiwei  GuanZhiwei Guan1Hongtao  CuiHongtao Cui2Mu-Mu  WeiMu-Mu Wei1Yi  ZhangYi Zhang1Jixiang  XuJixiang Xu1
  • 1School of Pediatric Medicine, Henan University of Traditional Chinese Medicine, Zhengzhou, China
  • 2Chongqing Hospital Of Traditional Chinese Medicine, Chongqing, China

The final, formatted version of the article will be published soon.

The management of pediatric severe asthma poses significant challenges for families. When faced with the choice between targeted biologics like omalizumab and widely used complementary alternative medicine (CAM), families navigate a complex decision-making process influenced by multiple factors. This review adopts a family-centered perspective to systematically analyze key factors influencing this trade-off: treatment goals (extending beyond clinical metrics to focus on quality of life), risk perception (shaped by subjective constructs and lacking direct evidence for comparative risk assessments), treatment burden (often overlooked hidden costs), and the current state of shared decision-making (SDM). Analysis reveals that family decision-making is a multidimensional construct shaped by four core elements: value systems, lived experiences, risk perception patterns, and tolerance for treatment burden. Notably, the significant gap in risk perception evidence leads to subjective risk assessments dominating decisions, particularly in CAM choices. Treatment burden, a critical hidden cost, is often marginalized in decisions, hindering effective SDM. Health equity further profoundly impacts choices.The conclusion emphasizes the need for clinical practice to shift toward family-centered care by addressing real-world needs, routinely evaluating treatment burden, optimizing risk communication, overcoming SDM barriers, and promoting health equity. Future research must fill evidence gaps in risk perception, develop SDM tools, and address culturally diverse family needs.

Keywords: Pediatric severe asthma, Family perspective, Omalizumab, Complementary Alternative Medicine (CAM), Treatment Decision-making, Risk Perception, treatment burden, Shared decision-making (SDM)

Received: 30 Apr 2025; Accepted: 10 Jun 2025.

Copyright: © 2025 CHEN, Xu, Qiu, Guan, Cui, Wei, Zhang and Xu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yan Xu, School of Pediatric Medicine, Henan University of Traditional Chinese Medicine, Zhengzhou, China

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