Use of traditional,complementary and alternative medicine in nine countries: A cross-sectional multinational survey

ObjectivesTraditional, complementary, and alternative medicine (TC&AM) play an exceptional role in health care around the world as many patients has sought a holistic approach.SettingIn this study, a multinational survey was developed and administered to obtain experience, attitude, and promotion information with regard to the international use of TC&AM among nine countries: Germany, United States, Japan, China, Malaysia, Vietnam, Russia, Kazakhstan, and United Arab Emirates (UAE). The survey was administered via online to members of SurveyMonkey Audience, a proprietary panel of respondents who were recruited from a diverse population worldwide.ResultsA total of 1071 participants has completed the survey. The participants were in favor of the treatments and therapies as well as expressed positive attitudes and also have used herbal medicine treatment more than acupuncture therapy and also used the modalities to promote metabolism rather than treating musculoskeletal diseases. Moreover, participants mentioned that TC&AM should be applied for treating and managing infectious diseases, such as COVID-19. Additionally, participants recommended using Facebook channel to promote its treatments and therapies.ConclusionBased on the results, this study provides initial insights on TC&AM that may influence the non-users globally and perhaps inspire a need for further research including more countries in different continents.     

The use of complementary and alternative medicine (CAM) among cancer patients at a tertiary hospital in Malaysia

PurposeComplementary and alternative medicine (CAM) use among cancer patients is increasing over the years. Some types of CAM may interact with conventional cancer therapy or may cause serious adverse effects. This study was designed to determine the prevalence of CAM use among cancer patients during cancer therapy and to identify CAM users’ characteristics, perception, reasoning, expectation and disclosure of CAM use.MethodThis cross-sectional study was conducted between July 2017 to October 2017, on 121 cancer patients in oncology and hematology clinics and daycare of a tertiary hospital in Kuala Lumpur, Malaysia. Study data was collected using a self-administered questionnaire.ResultsThe prevalence of CAM use among cancer patients was found to be 61.2 %. Multivariate logistic regression analysis showed that CAM use was associated with change in outlook on life after development of cancer. The most frequently used types of CAM were vitamins and Islamic medical practices. Majority of patients were guided by family and friends’ suggestions towards using CAM. Most patients expected CAM to cure their disease. The percentage of patients who disclosed CAM use to the doctors was slightly higher than those who did not disclose CAM use.ConclusionThe use of CAM was found to be remarkably high. Rate of non-disclosure of CAM use was high indicating the need for enhancement of doctor- patient relationship for effective patient’s care. Future research is needed with large sample of patients to provide better representation of the population and to help understand patients’ beliefs and perception more.     

Use of complementary and alternative medicine by patients with cluster headache: results of a multi-centre headache clinic survey

OBJECTIVES: To evaluate the rates, pattern, satisfaction with, and presence of predictors of complementary and alternative medicine (CAM) use in a clinical population of patients with cluster headache (CH). DESIGN AND SETTING: One hundred CH patients attending one of three headache clinics were asked to undergo a physician-administered structured interview designed to gather information on CAM use. RESULTS: Past use of CAM therapies was reported by 29% of the patients surveyed, with 10% having used CAM in the previous year. Only 8% of the therapies used were perceived as effective, while a partial effectiveness was reported in 28% of CAM treatments. The most common source of recommendation of CAM was a friend or relative (54%). Approximately 62% of CAM users had not informed their medical doctors of their CAM use. The most common reason for deciding to try a CAM therapy was that it offered a "potential improvement of headache" (44.8%). Univariate analysis showed that CAM users had a higher income, had a higher lifetime number of conventional medical doctor visits, had consulted more headache specialists, had a higher number of CH attacks per year, and had a significantly higher proportion of chronic CH versus episodic CH. A binary logistic regression analysis was performed and two variables remained as significant predictors of CAM use: income level (OR=5.7, CI=1.6-9.1, p=0.01), and number of attacks per year (OR=3.08, CI=1.64-6.7, p<0.0001). CONCLUSION: Our findings suggest that CH patients, in their need of and quest for care, seek and explore both conventional and CAM approaches, even though only a very small minority finds them very satisfactory.     

Bridging the gap: decision-making processes of women with breast cancer using complementary and alternative medicine (CAM)

Goals of work The purpose of this study was to explore the personal and social processes women with breast cancer engaged in when making decisions about complementary and alternative medicine (CAM). The overall aim was to develop a conceptual model of the treatment decision-making process specific to breast cancer care and CAM that will inform future information and decision support strategies. Materials and methods Grounded theory methodology explored the decisions of women with breast cancer using CAM. Semistructured interviews were conducted with 20 women diagnosed with early-stage breast cancer. Following open, axial, and selective coding, the constant comparative method was used to identify key themes in the data and develop a conceptual model of the CAM decision-making process. Main results The final decision-making model, Bridging the Gap, was comprised of four core concepts including maximizing choices/minimizing risks, experiencing conflict, gathering and filtering information, and bridging the gap. Women with breast cancer used one of three decision-making styles to address the paradigmatic, informational, and role conflict they experienced as a result of the gap they perceived between conventional care and CAM: (1) taking it one step at a time, (2) playing it safe, and (3) bringing it all together. Conclusions Women with breast cancer face conflict and anxiety when making decisions about CAM within a conventional cancer care context. Information and decision support strategies are needed to ensure women are making safe, informed treatment decisions about CAM. The model, Bridging the Gap, provides a conceptual framework for future decision support interventions.     

Use of complementary and alternative medicine by patients with breast cancer: observations from a health-care survey

Goals of the work The aim of this study was to assess the period prevalence and identify predictors of the use of complementary and alternative medicine (CAM) among women with breast cancer.Patients and methods In a cross-sectional study, 263 women participating in a quality of life survey reported on CAM use. Differences between CAM users and nonusers were evaluated using logistic regression.Results About 3 years after diagnosis the period prevalence of CAM use among women with breast cancer was 36%. Younger women reported usage of CAM more often than older women. Associations between remote disease, pain and psychosocial variables were found. Involvement in self-help groups and active participation in leisure activities were associated with CAM use; this may indicate differences in the patients ability to cope with the disease. Most patients were informed of CAM by a physician.Conclusions Involvement in self-help groups and leisure activities were associated with CAM use, indicating differences in the patients ability to cope. Further research is necessary to evaluate the safety of CAM and to determine the value of CAM in health care.     

Taiwanese nurses' attitudes towards and use of complementary and alternative medicine in nursing practice: a cross-sectional survey

BACKGROUND: Increasingly, nurses in Western countries express positive attitudes to complementary and alternative medicine (CAM) but lack knowledge, access to education and organisational policy to guide practice. It is unclear whether nurses in developed Asian countries mirror or differ from this profile. OBJECTIVES: To determine the attitudes towards and use of CAM by registered nurses in Taiwan. DESIGN: Cross sectional survey. SETTING: A Nursing College in eastern Taiwan. PARTICIPANTS: Registered nurses (N=170) working in various clinical settings who were studying a post registration Bachelor of Nursing conversion course. METHODS: Questionnaire distributed to nurses during class time. RESULTS: Most nurses had positive attitudes to CAM and most used therapies, like massage, occasionally in practice. However, none had formal qualifications in CAM and most perceived that there were insufficient resources or organisational policy to facilitate practice. CONCLUSIONS: Taiwanese nurses need more formal education about CAM and require access to clear policies regarding the safe use of CAM in nursing practice.     

Presenting the alternative: cancer and complementary and alternative medicine in the Canadian print media

Goals of work Cancer patients repeatedly identify the mass media as a primary information source to support their decisions to use complementary and alternative medicine (CAM). Accordingly, the objectives of this research are to describe: (1) what has been reported in the Canadian print media regarding CAM treatment for cancer between January 1, 1990 and December 31, 2005; (2) how that information was represented; and (3) trends in reporting frequency and reporting characteristics. Materials and methods Content analysis of all articles published in four Canadian newspapers and five magazines that discussed CAM treatment for cancer. Main results 915 articles were identified: 760 newspaper articles and 155 magazine articles. The CAM therapies most commonly described in media reports were: natural health products, CAM therapies in general, special diets, spirituality, and meditation. CAM therapies were most often described in a positive fashion, and CAM use was most often described as a potential cure for cancer. The majority of articles did not present information on the risks, benefits, and costs of CAM use and few provided a recommendation to speak with a health care provider before use. Conclusions The results correspond with the commercial interests of media outlets, as coverage appears to be focused around entertainment rather than information provision. The media play a role in introducing a range of treatment options to cancer patients that may not be discussed by conventional health care providers; however, the information provided in media articles appears insufficient to assist patients with informed decision-making.     

Prevalence of complementary and alternative medicine use in cancer patients during treatment

Goals of work To assess complementary and alternative medicine (CAM) therapies being utilized by cancer patients during treatment and communication about CAM usage between the patient and physician.Patients and methods Newly diagnosed cancer patients receiving chemotherapy or radiation therapy were recruited to complete a CAM survey within 2 weeks after the termination of treatment. Patients were queried on which CAM modalities they utilized and whether or not they were discussed with either their oncologist or primary care physician.Main results Of the patients surveyed, 91% reported using at least one form of CAM. The most widely used forms of CAM were prayer, relaxation and exercise. CAM users tended to be women chemotherapy patients with at least a high school education. Of the patients using CAM, 57% discussed the use of at least one of these therapies with their oncologist or primary care physician. The most frequent CAM modalities discussed with at least one physician were diets, massage, and herbal medicine.Conclusions An overwhelming proportion of cancer patients are using CAM, particularly prayer, relaxation, and exercise. However, patients may not discuss the use of CAMs at all or fully with their physician; if they do, it is most likely to be their oncologist, but not about the most frequently used CAMs. Future research needs to assess effective ways for oncologists to gather information about CAM usage by patients during allopathic treatment and discern ways these therapies may enhance or interfere with traditional cancer treatments.     

Use of complementary and alternative medicine practitioners by people with physical disabilities: estimates from a National US Survey

Purpose. To estimate the prevalence of complementary and alternative medicine (CAM) practitioner use, assess the reasons for use, and determine the symptoms for which CAM practitioners were consulted in a national US sample of insured adults with physical disabilities.

Methods. Data for this study come from a longitudinal survey conducted in 2000 and 2001 on a national sample of 830 adults with health insurance who had one of four disabling conditions: multiple sclerosis, cerebral palsy, spinal cord injury, and arthritis. Estimates of annual prevalence and reasons and symptoms for which CAM practitioners were consulted are derived from cross-sectional analysis of the 2001 survey data. Prior use of CAM was assessed using the 2000 survey.

Results. CAM practitioners were consulted by 19% of the sample, a rate similar to, or higher than the general population. CAM use was more prevalent among women than men (24 vs. 10%), in the Western US (30%) compared to the Midwest (20%) Northeast (14%), and South (10%) and among prior users (62%) compared to non-users (8%). There were no significant differences in CAM use by condition, although individuals with spinal cord injury reported the lowest use (14%). Common symptoms treated were pain (80%), decreased functioning (43%), and lack of energy (24%). Common reasons for using CAM practitioners included lifestyle choice (67%) and because they are perceived to be more effective than conventional medicine (44%).

Conclusions. Evidence from the current survey suggests that a significant proportion of people with physical disabilities consult CAM practitioners. Many of those who use CAM do so because it fits their lifestyle and because they perceive it to be more effective than conventional medicine for treating common symptoms including pain and decreased functioning.     

Use of complementary and alternative medicine practitioners by people with physical disabilities: Estimates from a National US Survey

Purpose. To estimate the prevalence of complementary and alternative medicine (CAM) practitioner use, assess the reasons for use, and determine the symptoms for which CAM practitioners were consulted in a national US sample of insured adults with physical disabilities.

Methods. Data for this study come from a longitudinal survey conducted in 2000 and 2001 on a national sample of 830 adults with health insurance who had one of four disabling conditions: multiple sclerosis, cerebral palsy, spinal cord injury, and arthritis. Estimates of annual prevalence and reasons and symptoms for which CAM practitioners were consulted are derived from cross-sectional analysis of the 2001 survey data. Prior use of CAM was assessed using the 2000 survey.

Results. CAM practitioners were consulted by 19% of the sample, a rate similar to, or higher than the general population. CAM use was more prevalent among women than men (24 vs. 10%), in the Western US (30%) compared to the Midwest (20%) Northeast (14%), and South (10%) and among prior users (62%) compared to non-users (8%). There were no significant differences in CAM use by condition, although individuals with spinal cord injury reported the lowest use (14%). Common symptoms treated were pain (80%), decreased functioning (43%), and lack of energy (24%). Common reasons for using CAM practitioners included lifestyle choice (67%) and because they are perceived to be more effective than conventional medicine (44%).

Conclusions. Evidence from the current survey suggests that a significant proportion of people with physical disabilities consult CAM practitioners. Many of those who use CAM do so because it fits their lifestyle and because they perceive it to be more effective than conventional medicine for treating common symptoms including pain and decreased functioning.     

Quality of life and complementary and alternative medicine use among cancer patients in Turkey

AimThe purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients.MethodsThis cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients’ characteristics and quality of life.ResultsSome form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients’ quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies.ConclusionCAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients’ decisions.     

Factors associated with complementary medicine use in pediatric musculoskeletal conditions: Results from a national survey

ObjectivesComplementary and alternative medicine (CAM) use is common in children, but its use has only been investigated in children with musculoskeletal conditions (MSK) to a limited extent. We aimed to characterize factors associated with CAM use in children with MSK conditions.MethodsWithin the 2012 National Health Interview Survey dataset (including its child CAM supplement), we examined factors associated with CAM use in children with MSK conditions and performed an analysis examining the perceived usefulness of CAM therapies for MSK conditions.ResultsOverall, there were 10,218 children in the dataset. 28.0% of children with MSK conditions used CAM, compared to 8.8% of children without MSK conditions. Gender (p = 0.003), region (p = 0.001), race (p = 0.001), parental CAM use (p < 0.001), education (<0.001), and having anxiety, stress or depression (p = 0.030) were correlated with CAM use. Among 90 children who reported on CAM use, 89.7% said that CAM helped some or a great deal for their MSK condition.ConclusionsSeveral factors, particularly parental education and parental CAM use, were associated with CAM use, and self-reported improvement rates were high. Interventional trials are needed to determine the efficacy of specific CAM therapies for treating different MSK conditions in children.     

Use of complementary and alternative medicine in patients suffering from primary headache disorders

Complementary and alternative medicine (CAM) is increasingly common in the treatment of primary headache disorders despite lack of evidence for efficacy in most modalities. A systematic questionnaire-based survey of CAM therapy was conducted in 432 patients who attended seven tertiary headache out-patient clinics in Germany and Austria. Use of CAM was reported by the majority (81.7%) of patients. Most frequently used CAM treatments were acupuncture (58.3%), massage (46.1%) and relaxation techniques (42.4%). Use was motivated by 'to leave nothing undone' (63.7%) and 'to be active against the disease' (55.6%). Compared with non-users, CAM users were of higher age, showed a longer duration of disease, a higher percentage of chronification, less intensity of headache, were more satisfied with conventional prophylaxis and showed greater willingness to gather information about headaches. There were no differences with respect to gender, headache diagnoses, headache-specific disability, education, income, religious attitudes or satisfaction with conventional attack therapy. A higher number of headache days, longer duration of headache treatment, higher personal costs, and use of CAM for other diseases predicted a higher number of used CAM treatments. This study confirms that CAM is widely used among primary headache patients, mostly in combination with standard care.     

Anti-cancer effects of traditional Korean wild vegetables in complementary and alternative medicine

This research study explored the anti-cancer effects of natural materials in South Korea. Although South Korea has a long history of traditional medicine, many natural materials of South Korea have not yet been introduced to the rest of the world because of language barriers and inconsistent study conditions. In the past 3 years, 56 papers introducing 56 natural materials, which have anti-cancer effects, have been published by scientists in South Korea. Further, these studies have introduced five kinds of natural materials presented in research papers that were written in Korean and are therefore virtually unknown overseas. The anti-cancer effects were confirmed by 2–3 cancer markers in the majority of the studies, with the most common targets being breast cancer cells and gastric cancer cells. These cancers have the greatest incidence in South Korea. The natural materials studied not only exhibit anti-cancer activity but also display anti-inflammatory, anti-oxidative stress, and anti-diabetic activities. They have not yet been used for the direct treatment of disease but have potential as medicinal materials for alternative and complementary medicine for the treatment of many modern diseases. Many natural materials of South Korea are already known all over the world, and with this study, we hope to further future research to learn more about these natural medicines.