Knowledge, attitudes, and practices among health care providers regarding complementary and alternative medicine in Trinidad and Tobago

Mandreker Bahall,George Legall

doi:10.1186/s12906-017-1654-y

Abstract

BackgroundHealth care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. We explored the knowledge, attitudes, and practices of health care providers regarding CAM.MethodsThis cross-sectional study was conducted between March 1 and July 31, 2015 among health care providers working mainly in the public sector in Trinidad and Tobago. A 34-item questionnaire was distributed and used for data collection. Questionnaire data were analysed using inferential and binary logistic regression models.ResultsResponse rate was 60.3% (362/600). Responders were 172 nurses, 77 doctors, 30 pharmacists, and 83 other health care providers of unnamed categories (mainly nursing assistants). Responders were predominantly female (69.1%), Indo-Trinidadian (55.8%), Christian (47.5%), self-claimed “very religious” (48.3%), and had <5 years of working experience (40.6%). The prevalence of CAM use was 92.4% for nurses, 64.9% for doctors, 83.3% for pharmacists, and 77.1% for other health care providers. The majority (50–75%) reported fair knowledge of herbal, spiritual, alternative, and physical types of CAM, but had no knowledge of energy therapy and therapeutic methods. Sex, ethnicity, and type of health care provider were associated with both personal use and recommendation for the use of CAM. Predictors of CAM use were sex, religion, and type of health care provider; predictors of recommendation for the use of CAM were sex and type of health care provider. About half of health care providers (51.4%) and doctors (52%) were likely to ask their patients about CAM and <15% were likely to refer patients to a CAM practitioner. However, health care providers expressed interest in being educated on the subject. Doctors (51.9%) and pharmacists (63.3%) said that combination therapy is superior to conventional medicine alone. Less than 10% said conventional medicine should be used alone.ConclusionKnowledge about CAM is low among health care providers. The majority engages in using CAM but is reluctant to recommend it. Predictors of CAM use were sex, religion, and profession; predictors of recommendation for the use of CAM were sex and profession. Health care providers feel the future lies in integrative medicine.

Highlights

Health care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use
There was no significant correlation between the reported level of knowledge of CAM and the Health care provider (HCP) category, with the exception of pharmacists (Table 6)
CAM use was more prevalent among nurses, followed by pharmacists, doctors, and other HCPs

Summary

Introduction

Health care providers are often ill prepared to interact about or make acceptable conclusions on complementary and alternative medicine (CAM) despite its widespread use. CAM is defined as “a group of diverse medical and health care systems, practices, and products that are not generally considered part of conventional medicine” [1]. In Trinidad and Tobago, inhabitants have been traditionally exposed to home remedies and unconventional medical practices [7] that are still used in part due to the lack of available conventional health care [8] and to improve holistic care [9, 10]. Other types of CAM used in Trinidad and Tobago are special prayers [18], a multitude of vitamins for healing and vitality (“boosters”), chelation therapy, Reiki therapy [19], Chinese and Ayurvedic medicine [18] and acupuncture [20]

Methods

Results

Discussion

Conclusion