Abstract
BackgroundThe inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The objective of this study was to assess PFH and CAM use among breast cancer patients undergoing chemotherapy.MethodsA cross-sectional study was performed at two chemotherapy providers. Patients were questioned about use of three categories of CAM, mind-body practices (MBPs), natural products (NPs) and traditional medicine (TM). PFH was also examined separately from CAM to better characterise the patterns of CAM and PFH used during chemotherapy.ResultsA total of 546 eligible patients participated in the study; 70.7% (n = 386) reported using some form of CAM, and 29.3% (n = 160) were non-CAM users. When PFH was excluded as a CAM, fewer patients reported the use of CAM (66.1%; n = 361). The total number of patients who used MBPs decreased from 342 to 183. The most common CAM use category was NPs (82.8%), followed by MBPs (50.7%), and TM (35.7%). CAM users were more likely to have a tertiary education (OR 2.11, 95% CI 1.15–3.89 vs. primary/lower), have household incomes > RM 3,000 (≈944 USD) per month (OR 2.32, 95% CI 1.40–3.84 vs. ≤RM 3,000 (≈944 USD)), and have advanced cancer (OR 1.75, 95% CI 1.18–2.59 vs. early stage cancer), compared with non-CAM users. The CAM users were less likely to have their chemotherapy on schedule (OR 0.24, 95% CI 0.10–0.58 vs. chemotherapy postponed) than non-CAM users. Most MBPs were perceived to be more helpful by their users, compared with the users of NPs and TM.ConclusionCAM use was prevalent among breast cancer patients. Excluding PFH from the definition of CAM reduced the prevalence of overall CAM use. Overall, CAM use was associated with higher education levels and household incomes, advanced cancer and lower chemotherapy schedule compliance. Many patients perceived MBP to be beneficial for improving overall well-being during chemotherapy. These findings, while preliminary, clearly indicate the differences in CAM use when PFH is included in, and excluded from, the definition of CAM.Electronic supplementary materialThe online version of this article (doi:10.1186/1472-6882-14-425) contains supplementary material, which is available to authorized users.
Highlights
The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use
Participants were selected based on the following criteria: breast cancer patients who had undergone at least one cycle of chemotherapy and were waiting for their subsequent chemotherapy infusion, no previous history of cancer or previous chemotherapy, mentally and physically competent to participate in the study, and able to communicate in English, Bahasa Malaysia (Malay language), Mandarin or Tamil
Correlates of CAM use The multivariate logistic regression analysis revealed that CAM users (PFH included in CAM; PFH excluded from CAM) were more likely to have a tertiary education (odds ratio (OR) 2.33, 95% confidence interval (CI) 1.22–4.47; OR 2.11, 95% CI 1.15–3.89 vs. primary school/lower), have average household incomes > RM 3,000 (≈944 USD) per month (OR 3.41, 95% CI 1.92–6.03; OR 2.32, 95% CI 1.40–3.84 vs. ≤RM 3,000 (≈944 USD)), with advancedstage cancer than non-CAM users
Summary
The inclusion of prayer-for-health (PFH) in the definition of complementary alternative medicine (CAM) has resulted in higher levels of CAM use. The use of complementary alternative medicine (CAM) has become increasingly popular [1], among cancer patients [2,3]. The prevalence of CAM use by cancer patients varies by population, study design and by different study definitions of CAM [16]. In Malaysia, the term traditional and complementary alternative medicine (TM&CAM) is used to denote health-related practices that are not provided by registered conventional medical practitioners to prevent, treat and/or manage illness, and/or preserve the mental and physical well-being of individuals [17]. The prevalence of CAM use by breast cancer patients ranges from 51.0 to 88.3% [19,20,21]. The CAM practised in Malaysia reflects the diverse population of Malay, Chinese, Indian and indigenous cultures. These herbal preparations and products are imported from India as tablets, oils, ointments, metals, mineral concoctions and herbal powders [25]
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