Complementary and alternative medicine use in the Amish

OBJECTIVE: To examine the rate of utilization of complementary and alternative medicine (CAM) in Amish women, a population that traditionally uses non-mainstream medicine. METHODS & RESULTS: Sixty-six Amish women completed a survey concerning their use of CAM. Thirty-six percent of the Amish women used at least one form of CAM, primarily reporting a use of diet and nutrition programs, herbal therapies, and chiropractic medicine. In addition, ten pregnant Amish women reported using echinacea, St. John's Wort, red clover, garlic and ginseng. CONCLUSION: This survey highlights the need to address potential adverse effects of herbal therapies in young women who are a member of a group that may use non-mainstream medicine.     

Complementary and alternative medicine use in multiracial Singapore

OBJECTIVE: To determine the prevalence of complementary and alternative medicine (CAM) use in Singapore, the factors influencing CAM use, and the attitudes, beliefs and perceptions of the general population towards CAM. DESIGN: An interviewer-administered questionnaire survey in a housing estate with demographic and socioeconomic characteristics closely matching that of Singapore. RESULTS: 76% (95% C.I. 73.9-77.9%) used CAM over a 12-month period. Females were 2.1 times (95% C.I. 1.3-3.4) more likely than males to use CAM. Chinese (84%) were the most frequent users, followed by Malays (69%) and Indians (69%), with adjusted odds ratios of 0.4 (95% C.I. 0.2-0.7) for Malays and 0.4 (95% C.I. 0.2-0.8) for Indians. Traditional Chinese Medicine (88%) was the most widely used form of CAM, followed by Traditional Malay (Jamu) Medicine (8%) and Traditional Indian (Ayuverdic) Medicine (3%). Similar to western studies, CAM was more likely to be used for maintenance of health than for treatment of illness. Different from western studies, CAM use was not independently associated with household income, marital status, age and education. Seventy-four percent did not discuss their use of CAM with their western-trained doctors. CONCLUSIONS: The high prevalence of CAM use in multi-racial Singapore suggests the same may be true in other Asian countries. Western-trained doctors need to understand CAM better and communicate more with their patients regarding CAM use. The lack of a scientific evidence base for most forms of CAM notwithstanding, its ubiquitous use worldwide is something that governments and the medical profession cannot afford to ignore.     

Complementary and alternative medicine use among patients with thoracic malignancies

Purpose

Complementary and alternative medicine (CAM) use has been increasing among cancer patients. This study characterizes the use of CAM among patients with thoracic malignancies.

Methods

This cross sectional study was conducted at a National Cancer Institute-designated comprehensive cancer center among adult patients diagnosed with thoracic malignancies. The primary outcome was a self-reported use of CAM, defined as the use of any type of CAM beyond routine vitamin/mineral supplementation alone. A logistic regression model was developed to explore predictors of CAM use.

Results

A total of 108 patients completed a standardized survey (59 % response rate). Overall, 42 % of respondents reported the use of at least one type of CAM. Users and non-users of CAM did not differ based upon demographics, diagnosis, staging, smoking status, quality of life, or perceived understanding of cancer diagnosis. In the multivariate analysis, patients who reported feeling fearful about their future were four times more likely to be CAM users when compared to those who did not specify this emotion (odds ratio?=?4.18; 95 % CI?=?1.23–14.12; p?=?0.02). Commonly cited reasons for CAM use were to support one’s self, boost immunity, and for improvements in emotional and/or spiritual well-being.

Conclusions

Prevalence of CAM use among cancer patients in this study was similar to the general US population. Feeling fearful about the future was associated with CAM use. Results suggest that patients may be turning to CAM as a therapeutic adjunct to actively cope with emotional distress surrounding the cancer experience.     

Complementary and alternative medicine use among veterans with chronic noncancer pain

We describe prior use and willingness to try complementary and alternative medicine (CAM) among 401 veterans experiencing chronic noncancer pain and explore differences between CAM users and nonusers. Participants in a randomized controlled trial of a collaborative intervention for chronic pain from five Department of Veterans Affairs (VA) primary care clinics self-reported prior use and willingness to try chiropractic care, massage therapy, herbal medicines, and acupuncture. Prior CAM users were compared with nonusers on demographic characteristics, pain-related clinical characteristics, disease burden, and treatment satisfaction. A majority of veterans ( n = 327, 82%) reported prior use of at least one CAM modality, and nearly all (n = 399, 99%) were willing to try CAM treatment for pain. Chiropractic care was the least preferred option, whereas massage therapy was the most preferred (75% and 96%, respectively). CAM users were less likely to have service-connection disabilities (54% vs 68%; chi square = 4.64, p = 0.03) and reported having spent a larger percentage of their lives in pain (26% vs 20%; Z = 1.40, p = 0.04) than nonusers. We detected few differences between veterans who had tried CAM and those who had not, suggesting that CAM may have broad appeal among veterans with chronic pain. Implications for VA policy and practice and for clinicians treating veterans with chronic pain are discussed.     

Complementary and alternative medicine use among breast cancer survivors

OBJECTIVES: The use complementary and alternative medicine (CAM) by patients with breast cancer and survivors has been widely studied. However, scant research has focused on the degree to which CAM activity is related to the cancer experience, as opposed to use for other reasons. The study objective was to examine the use of CAM in a sample of patients with breast cancer. Additional objectives were to measure associations between psychosocial and medical factors and CAM use both related and unrelated to a breast cancer diagnosis. DESIGN: Breast cancer survivors (N=115) at least 1 year beyond active medical treatment were recruited during routine clinic visits. Survey data collected via structured telephone interview focused on CAM use, motivations for use, perceived risk of cancer recurrence, and breast cancer-specific and general measures of anxiety. RESULTS: Sixty-nine percent (69%) of participants reported use of CAM. Of CAM users, 73% reported initiating or changing CAM activity specifically because of their cancer diagnosis. Patients engaging in CAM for cancer-related reasons were younger (p<0.001) and had been diagnosed with cancer at a younger age (p<0.01). Although overall anxiety scores in this sample were not significantly elevated, higher trait anxiety was associated with CAM use related to one's cancer diagnosis. CONCLUSIONS: Rate of CAM use was high, with the majority of CAM users associating that activity with their breast cancer. Anxiety levels varied between nonusers, CAM users for cancer, and CAM users for other reasons, with highest trait anxiety among those who associate their CAM use with cancer. Assessing motivations for CAM use may be important in future examinations of the relationship between CAM use and quality of life among breast cancer survivors.