Alternative Medicine Providers Research Articles

Preferences For Health Information and Participation in Decision Making: The Patients’ Perspectives for Hospital Improvement

Patients of varying generations demand varying approaches. Additionally, hailing from diverse indigenous cultures and religions, they have distinct historical backgrounds that shape their personal qualities. In healthcare, holistic care is critical, and it must meet the dynamism and constant change of the world, while also taking generational gaps into account as a major concern in healthcare. This quantitative research made use of the descriptive, comparative (non-causal) design to compare the differences in the perceptions on the preferences for health information and participation in decision making among generational in-patients in a government-retained hospital for the 2nd quarter of 2021. Findings of the study revealed that the respondents had a good preference on health information on diagnosis, treatment, laboratory tests, self-care, and psychosocial while they are only had a fair preference of health information on complimentary or alternative medicine and healthcare provider. The Generation Z scored the highest of the four generations while the Baby Boomers scored the lowest. The respondents had a poor preference for participation in decision making on their diagnosis and treatment. They had a fair preference for participation in decision making on their laboratory tests but they had a good preference for participation in decision making on their self-care, complimentary or alternative medicine, and healthcare provider. They had a very good preference for participation in decision making on the psychosocial factors. The Baby Boomers scored the highest of the four generations, while the Generation Z scored the lowest. There was a significant difference in the perceptions on preference on health information. The Generation Z had a better preference on health information as compared to the Baby Boomers. Further, there was a significant difference in the perceptions for participation on decision making. The Baby Boomers, the Generation X, and the Generation Y are much better in terms of the perception of preferences for participation in decision making over the Generation Z. With the findings, a multi-generational health information and decision-making enhancement plan was created.

Trust in Conventional Healthcare and Utilization of Complementary and Alternative Medicine in South Tyrol, Italy: A Population-Based Cross-Sectional Survey.

This study explored the link between trust in conventional healthcare and consultations with complementary and alternative medicine (CAM) providers in South Tyrol, Italy's linguistically diverse region. A representative cross-sectional survey of 1,388 South Tyrolean adults assessed trust in conventional healthcare, general practitioners, and complementary and alternative medicine consultation frequencies and their determinants using chi-square tests and Kendall-Tau-b correlations. Seventy percent trusted the traditional healthcare system, with general practitioners as the primary trusted professionals. Trust is correlated with higher education and linguistic compatibility. A 5% subgroup, mostly women and multilinguals with lower education levels, showed uncertain trust. Over 80% had seen a general practitioner in the last year, while distrust was correlated with complementary and alternative medicine consultations. German and Ladin speakers, with higher education levels, were notably inclined towards complementary and alternative medicine consultations. Trust in South Tyrolean healthcare varied according to education level and language. While general practitioners remain central, there is a marked shift towards complementary and alternative medicine among specific groups.

Overcoming refusal of treatment in pediatric cancer without legal involvement: A descriptive case series from interviews with pediatric oncologists.

To describe strategies that pediatric oncologists utilize to persuade families to initiate or continue chemotherapy after refusing treatment, we examined transcripts from interviews of oncologists with relevant experience. We identified three cases in which the pediatric oncologists' approaches led to voluntary acceptance of recommended treatment without legal intervention. Strategies used include direct communication with alternative medicine providers, time-limited trial of alternative therapy, and praying with the family. While we cannot conclude whether these approaches could be generalized to other cases, they offer ideas for pediatric oncologists to consider when facing the decision to seek judicial involvement or discontinue persuasive efforts.

Supportive care for cancer-related symptoms in pediatric oncology: a qualitative study among healthcare providers

BackgroundThe aim of this study is to gain insight into the clinical experiences and perceptions that pediatric oncology experts, conventional healthcare providers, and complementary and alternative medicine (CAM) providers in Norway, Canada, Germany, the Netherlands, and the United States have with the use of supportive care, including CAM among children and adolescents with cancer.MethodsA qualitative study was conducted using semi-structured in-depth interviews (n = 22) with healthcare providers with clinical experience working with CAM and/or other supportive care among children and adolescents with cancer from five different countries. Participants were recruited through professional associations and personal networks. Systematic content analysis was used to delineate the main themes. The analysis resulted in three themes and six subthemes.ResultsMost participants had over 10 years of professional practice. They mostly treated children and adolescents with leukemia who suffered from adverse effects of cancer treatment, such as nausea and poor appetite. Their priorities were to identify the parents' treatment goals and help the children with their daily complaints. Some modalities frequently used were acupuncture, massage, music, and play therapy. Parents received information about supplements and diets in line with their treatment philosophies. They received education from the providers to mitigate symptoms and improve the well-being of the child.ConclusionsClinical experiences of pediatric oncology experts, conventional health care providers, and CAM providers give an understanding of how supportive care modalities, including CAM, are perceived in the field and how they can be implemented as adaptational tools to manage adverse effects and to improve the quality of life of children diagnosed with cancer and the families.

Abstract P645: Lower Satisfaction With Healthcare Providers’ Communication Associated With African Americans Seeking Care From Complementary and Alternative Medicine Providers: The Jackson Heart Study

Introduction: Individuals who use complementary and alternative medicine (CAM) have been found to have a greater sense of agency and control over their health, a goal that mainstream healthcare providers are also encouraged to promote through patient- centered communication. Patient-centered communication helps patients to feel heard, understood, and involved in their health decisions. The relationship between patient-centered communication and the use of CAM by African Americans has not been previously described. Hypothesis: African Americans who report less satisfaction with their healthcare providers’ communication will be more likely to seek CAM providers. Methods: This was a secondary analysis of data from the Jackson Heart Study, a longitudinal cohort study of African Americans in the Jackson, Mississippi metropolitan area. We performed a cross-sectional analysis of annual follow up data collected between 2004 and 2006. The exposure variables included participants’ satisfaction with their healthcare providers’ communication, which was captured by four items, which asked: “How often did your doctor or other healthcare providers listen carefully to you/explain things in a way you could understand/show respect for what you had to say/spend enough time with you.” These items were summed into a provider communication satisfaction index, with higher scores representing greater satisfaction. The outcome variables included whether the respondent had seen a CAM provider such as an acupuncturist, faith healer, or person who works with roots/herbs, in the previous year. Covariates included education, income, medication insurance status, sex, and age. The final analytic sample after listwise deletion was 2,999. Results: Few JHS participants reported having sought CAM provider options: 0.53% (95% CI: 0.33, 0.87) of participants reported having seen a person who uses acupuncture, 0.50% (95% CI: 0.30, 0.83) of participants reported having seen a faith healer, and 0.60% (95% CI: 0.38, 0.95) of participants reported having seen a person who deals with roots or herbs in the previous year. The provider communication satisfaction index, sum of the four provider satisfaction measures, ranged from 4 to 16 (mean: 14.84, SD: 2.09, 95% CI: 14.77, 14.92). Participants who indicated higher levels of satisfaction with their healthcare providers’ communication had lower odds of having seen a person who works with roots or herbs in the previous year (OR: 0.83, 95% CI: 0.70, 0.99, p= 0.036). Associations between the provider communication index and use of other forms of CAM (i.e, faith healing, acupuncture) were not statistically significant. Conclusions: Overall, this study indicates that patient satisfaction with provider communication is associated with African American patients’ exploration of care from CAM providers, particularly those who work with roots and herbs.

Public sector engagement of private healthcare providers during the COVID-19 pandemic in Uttar Pradesh, India.

The COVID-19 pandemic has strained public health resources and overwhelmed health systems capacity of countries worldwide. In India, the private sector is a significant source of healthcare particularly in large states like Uttar Pradesh (UP). This study sought to examine: (i) the government's approach to engaging the private health sector in the COVID-19 response in UP; (ii) the effects of government's engagement on private providers' practices and (iii) the barriers and facilitators to effective private sector engagement during the period. While the literature acknowledges weaknesses in private sector engagement during emergencies, our study provides deep empirical insight into how this occurs, drawing on the UP experience. We reviewed 102 Government of UP (GOUP) policy documents and conducted 36 in-depth interviews with government officials, technical partners, and private providers at district- and state-levels. We developed timelines for policy change based on the policy review and analyzed interview transcripts thematically using a framework analysis. We found that GOUP's engagement of the private sector and private providers' experiences varied substantially. While the government rapidly engaged and mobilized private laboratories, and enlisted private hospitals to provide COVID-19 services, it undertook only limited engagement of solo private providers who largely acted as referral units for suspected cases and reported data to support contact tracing efforts. Informal private providers played no formal role in the COVID-19 response, but in one district supported community-level contact tracing. Allopathic, alternative medicine, and diagnostic private providers faced common barriers and facilitators affecting their engagement relating to provider fear, communication, testing capacity, case reporting, and regulations. The establishment of mixed diagnostic networks during COVID-19 demonstrates the potential for public-private collaboration, however, our study also reveals missed opportunities to engage smaller-scale private health providers and establish mechanisms to effectively communicate and mobilize them during the pandemic, and beyond.

Mimetic Self-Reflexivity and Intersubjectivity in Complementary and Alternative Medicine Practices: The Mirror Neuron System in Breast Cancer Survivorship.

This study examines complementary and alternative medicine (CAM) providers’ practices in the treatment of their breast cancer survivor (BCS) clients and interprets these practices within the context of existing neuroscientific research on the mirror neuron system (MNS). Purposive and snowball sampling was conducted to recruit CAM providers (N = 15) treating BCSs from integrative medicine centers, educational institutions, private practices, and professional medical associations across the United States. In-depth semi-structured interviewing (N = 252 single-spaced pages) and inductive qualitative content analysis reveal CAM therapeutic practices emphasize a diachronic form of mimetic self-reflexivity and a serendipitous form of mimetic intersubjectivity in BCS pain management to allow the providers to tune-in to their clients’ internal states over time and experience themselves as an embodied subject in an imaginative, shared space. By employing imagination and an intentional vulnerability in their embodied simulation of the others’ internal states, CAM providers co-create experiences of pain while recognizing what about the other remains an unknown. Although MNs provide the mechanism for imitation and simulation underlying empathy through a neuronally wired grasp of the other’s intentionality, the study suggests that examining mimetic self-reflexivity and intersubjectivity in the therapeutic space may allow for a shared simulation of participants’ subjective experiences of pain and potentially inform research on self-recognition and self-other discrimination as an index of self-awareness which implicates the MNS in embodied social cognition in imaginative ways.

Characteristics of persons with hand osteoarthritis visiting complementary and alternative medicine providers

ObjectiveTo examine the frequency of Complementary and Alternative Medicine (CAM) in a hand osteoarthritis (OA) population, and to compare demographic and clinical characteristics between persons with hand OA visiting vs. not visiting CAM providers. Methods300 persons with hand OA from the Nor-Hand study responded to questionnaires concerning demographic information, medical assessments and their use of CAM and other therapies. In addition, they answered questions about health-related quality of life, comorbidities, psychological health and joint symptoms. The characteristics of persons visiting vs. not visiting CAM providers were compared using chi-square tests and t-tests or Mann-Whitney tests, as appropriate. ResultsIn total 227 (75.7%) persons with hand OA had used CAM for their joint symptoms and 68 (22.7%) had visited CAM providers. Persons visiting CAM providers reported more severe joint pain when taking all joints into account (mean 4.5 vs. 3.9 on a 0–10 Numerical Rating Scale, p ​= ​0.05) and more frequent use of non-pharmacological interventions, conventional analgesics, opioids, and previous surgery on ligaments and joints compared with persons not visiting CAM providers. Persons visiting CAM providers also reported more comorbidities and anxiety symptoms and they were characterized by having a more approach-seeking behaviour. ConclusionPersons with hand OA in secondary care were frequently visiting CAM providers. Persons visiting CAM providers were characterized by more severe joint symptoms despite the use of non-pharmacological and pharmacological interventions compared with persons not visiting CAM providers.

The impact of COVID-19 on complementary and alternative medicine providers: A cross-sectional survey in Norway

BackgroundThe Norwegian authorities decided in March 2020 to implement a nationwide lockdown to prevent spread of the COVID-19 virus. The lockdown had vast socioeconomic consequences for the society. The aim of this study was to investigate how COVID-19 affected Complementary and Alternative Medicine (CAM) providers’ practice, financial situation, recommendations to patients, and how they perceived their future practice as CAM providers. MethodData were collected in this cross-sectional survey using a self-administrated electronic questionnaire. A total of 581 CAM providers completed the questionnaire, which was designed to describe consequences for CAM providers and their clinical practice caused by the nationwide lockdown. Descriptive statistics were carried out using frequency analyses to describe the demographics and consequences of the lockdown. Between group differences (gender and age) were analyzed using Pearson chi-square tests and Fisher’s exact tests for categorical variables, and ANOVA tests and t-tests for continuous variables. Significance level was defined as p < 0.05 without adjustment for multiple comparisons. ResultDuring the nationwide lockdown of Norway, 38.4% of the respondents were able to provide CAM treatment to their patients. Of those, the majority (96.4%) had reorganized their clinical practice in accordance with COVID-19 hygiene regulations, offered video consultations (57.4%) or telephone consultations (46.6%). To manage financially during the lockdown, half of the providers spent their savings (48.7%). More than one third (35.1%) was supported by their partner, and 26.7% received compensation from the Norwegian state. A total of 26.3% of the CAM providers had other paid work that provided them with income. Nearly a fifth (18.6%) borrowed money from friends and family, changed their loan terms, or took out new bank loans. More than half (62.7%) expressed uncertainty about the future of their practice. CAM providers who had reorganized their practice to online consultations were more optimistic. ConclusionThe impact of COVID-19 on CAM providers was considerable. It adversely affected their clinical practice, financial situation, and view on their future practice. To ensure that the health needs of the Norwegian population regarding CAM use are met during pandemic times like COVID-19, it is recommended to support and train CAM providers in the development of online CAM services, as well as efficient implementation of infection prevention and control measures.

Large Scale Internet-based Survey of Patients With a Myeloproliferative Neoplasm: Opinions and Experiences Regarding SARS-CoV-2 (COVID-19) Vaccination Strategies in 2021.

Supplemental Digital Content is available in the text.

Stress Cardiomyopathy Due to Exogenous Thyrotoxicosis From T3 Supplementation

Background: Wilson’s Temperature Syndrome (WTS) refers to a constellation of nonspecific symptoms, some of which include a low-normal body temperature, headaches, and fatigue. WTS was rejected by the American Thyroid Association as a valid medical diagnosis in 2005. Originally proposed in 1990 by Dr. E Denis Wilson, the etiology was theorized to be an impaired ability to convert T4 to T3, although this was not corroborated in thyroid lab abnormalities. Despite being publicly rebuffed as a true medical diagnosis, WTS has continued to gain traction amongst certain alternative medical groups and is treated with T3 supplementation. The development of a stress cardiomyopathy due to T3 supplementation is rare. Extrapolating from endogenous thyroid mediated stress cardiomyopathy and T4 supplementation induced stress cardiomyopathy, the pathophysiologic mechanism is likely excessive sympathetic activation. Clinical Case: A 58-year old female with no prior cardiac history presented to the emergency department with chest pain. Physical exam revealed a euvolemic appearing women, with intact and symmetric distal pulses, and a normal cardiac exam without murmurs or other abnormal heart sounds. There were no abnormal lung sounds. Her O2 sats were normal on room air. EKG and CXR were unremarkable. Her troponin was elevated (3.7 ng/mL, n< 0.034 ng/mL) and her BNP was elevated (4,568 pg/mL, n< 150 pg/mL). The patient was given aspirin and started on therapeutic heparin given concern for NSTEMI. Echocardiogram revealed an ejection fraction of 30% with hypokinesis of the entire apex and mid ventricle, raising concern for a stress cardiomyopathy.Coronary angiogram was performed which demonstrated no coronary artery disease. The patient underwent a cardiac MRI which confirmed a stress cardiomyopathy. Meanwhile, her laboratory workup was completed which revealed an undetectable TSH, a low T4 (0.53 ng/dL, n 0.7-1.8 ng/dL), and an elevated T3 (6.37 pg/mL, n 1.71-3.71 pg/mL). Patient endorsed taking oral liothyronine (T3) at doses of 5-40 mcg BID over the past 6 weeks per her alternative medicine provider for treatment of WTS. Her stress cardiomyopathy was presumed to be due to her exogenous thyrotoxicosis from T3 supplementation. She was counseled on the importance of cessation of T3 supplementation, and was started on heart failure medications. On hospital day 3, her T3 normalized to 2.73 pg/mL, and T4 remained low (0.4 pg/mL). Follow-up echocardiogram four months later demonstrated an ejection fraction that had improved to 45%. Conclusion: This case highlights the importance of physician awareness of alternative medicine diagnoses and treatment regimens that affect thyroid hormones and may cause harm to patients. This case is an important reminder of the effect thyroid hormones have on coronary vasculature, myocytes and myocardial function.

Health-care access and utilization among individuals with low back pain in Iran: a WHO-ILAR COPCORD study

BackgroundLow back pain (LBP) is a major contributor to chronic pain and disability. The purpose of this study was to evaluate health-care access and utilization among patients with LBP in Iran. We also sought to study the pattern and characteristics of care-utilization behavior in these patients.MethodsData from the Community Oriented Program for Control of Rheumatic Diseases (COPCORD) were used for this study. Three cities (Zahedan, Sanandaj, Yazd) were selected to represent the Iranian population, with different socioeconomic status and ethnic, cultural, and religious background. Demographic data, acute or chronic LBP, disability index, and utilizing care from conventional medicine (CM), allied health providers (AHP), and complementary and alternative medicine (CAM) providers were recorded.ResultsOf 9101 patients, 38.6% reported LBP. Only 3.3% did not utilize care of any kind, 66.7% referred to CM providers, 20.8% to AHP, and 9.2% to CAM care. Health-care utilization was higher in female patients, older age, higher education, and higher disability index.ConclusionsThe findings of this study indicate a high rate of health-care utilization among patients with LBP in Iran. CM is the most prevalent health-care resource sought by patients. These findings could be used as a framework in developing more efficient health-care programs according to the needs of specific populations.

Colonoscopy videos on YouTube: Are they a good source of patient education?

Background and study aims Colonoscopy is an effective tool to prevent colorectal cancer. Social media has emerged as a source of medical information for patients.YouTube (a video sharing website) is the most popular video informative source. Therefore, we aimed to assess the educational quality of colonoscopy videos available on YouTube. Methods We performed a YouTube search using the keyword “colonoscopy” yielded 429 videos, of which 255 met the inclusion criteria. Colonoscopy Data Quality Score (C-DQS) was created to rate the quality of the videos (–10 to +40 points) based on a colonoscopy education video available on the Ameican Society of Gastrointestinal Endoscopy (ASGE) website. Each video was scored by six blinded reviewers independently using C-DQS. The Global Quality Score (GQS) was used for score validation. The intraclass correlation coefficient (ICC) was used to assess the similarity of the scores among reviewers. Results Professional societies had the highest number of videos (44.3 %). Videos from professional societies (6.94) and media (6.87) had significantly higher mean C-DQS compared to those from alternative medicine providers (1.19), companies (1.16), and patients (2.60) ( P < 0.05). Mean C-DQS score of videos from healthcare providers (4.40) was not statistically different than other sources. There was a high degree of agreement among reviewers for the videos from all sources (ICC = 0.934; P < 0.001). Discussion YouTube videos are a poor source of information on colonoscopy. Professional societies and media are better sources of quality information for patient education on colonoscopy. The medical community may need to engage actively in enriching the quality of educational material available on YouTube.

Collaborating with Complementary and Alternative Medicine (CAM) Providers When Writing HPV Vaccine Review Articles

Novel strategies are needed to address vaccine hesitancy (VH), which correlates with complementary and alternative medicine (CAM). In Switzerland, CAM providers play important roles in vaccine counseling of vaccine hesitant (VH) parents, and traditional vaccination messaging tends to overlook CAM provider perspectives. In the setting of a Swiss national research program on VH, our key strategy has been to work together closely with CAM providers. To assess the feasibility of generating educational human papillomavirus (HPV) vaccine materials that would interest VH healthcare providers (HCPs), we invited four CAM providers to co-author two HPV vaccine review articles for general practitioners. We conducted thematic analysis of CAM provider comments to identify patterns that could complement and improve vaccination messaging from CAM perspectives. We identified several themes and generated an inventory of CAM provider messaging recommendations related to language use, presentation of background information, nuanced statements regarding HPV vaccine efficacy and safety, and communication tools that would be important to VH HCPs. Contrary to our initial expectations, and in an inclusive, respectful atmosphere of open dialogue, we were able to productively finalize our manuscripts. In the opinion of the CAM co-authors, the manuscripts effectively considered the communication needs and perspectives of VH HCPs. Engaging with CAM providers appears to be a feasible and innovative avenue for providing vaccine information and designing communication tools aimed at VH healthcare providers.

Doctor YouTube's opinion on seasonal influenza: A critical appraisal of the information available to patients.

BackgroundSeasonal influenza is a respiratory illness caused by the influenza virus. During the 2017–2018 flu season, the Centers for Disease Control and Prevention noted approximately 959,000 hospitalizations and 79,400 deaths from influenza. We sought to evaluate the educational quality of informational videos pertaining to seasonal influenza on the popular social media forum, YouTube.MethodsUsing the keywords “seasonal influenza,” all videos from 28 January to 5 February 2017 were included and analyzed for characteristics, source, and content. The source was further classified as healthcare provider, alternative-medicine provider, the patient and/or their parents, company, media, or professional society. Videos about other categories of influenza (e.g. swine or Spanish) or in foreign languages were excluded. A total of 10 blinded reviewers scored each video independently.ResultsOverall, 300 videos were analyzed, with a median of 341.50 views, 1.00 likes, 0 dislikes, and 0 comments. Based on the average scores of videos by source, there was statistically significant difference in the average score among videos by video source (p < 0.01). Healthcare provider videos had the highest mean scores whereas alternative medicine provider videos had the lowest.ConclusionsAlthough the aforementioned video sources scored higher than others, these videos did not fulfill our criteria as far as educating patients thoroughly. Our data also suggest alternative medicine and patient source videos were misleading for patients.Clinical implications: Although videos by healthcare providers were a better source of information, videos on seasonal influenza were shown to be poor sources of valid healthcare information. This study reiterates the need for higher-quality educational videos on seasonal influenza by the medical community.

Determinants of vaccine hesitancy in Switzerland: study protocol of a mixed-methods national research programme

IntroductionVaccine hesitancy is a complex public health issue referring to concerns about the safety, efficacy or need for vaccination. Relatively little is known about vaccine hesitancy in Switzerland. This ongoing...

“We treat humans, not herds!”: A qualitative study of complementary and alternative medicine (CAM) providers’ individualized approaches to vaccination in Switzerland

Complementary and alternative medicine (CAM) providers' roles in parents' decision-making about vaccinations for their children have only recently begun receiving research attention, despite studies showing CAM to be used by 25–50% of the population in Western countries. This article examines how CAM practitioners discuss vaccinations with parents in Switzerland, with a focus on childhood vaccinations and human papillomavirus (HPV) vaccinations. We describe how the CAM providers we interviewed (N = 17) and observed during vaccination consultations (N = 18 observations with 5 providers) employed individualized approaches to vaccination. Triangulation of qualitative evidence from interviews and observations allowed us to analyze their discourses and descriptions of experiences (i.e. what they said) and their practices in situ (i.e. what they did). Evidence gathered shows that practitioners framed vaccination decisions as choices at individual and family levels rather than focusing on public health benefits and consequences. They articulated their perspectives in terms of personal clinical experiences and parents' wishes, concerns, and contexts. Such findings challenge recurring narratives depicting CAM providers as categorically anti-vaccination and suggest that approaches to address vaccine hesitancy in clinical practice could benefit from communication and relational approaches similar to those demonstrated by participants in this study. Such approaches include taking time to understand parents’ wishes, involving them in vaccination decisions, and taking their concerns seriously.

(Re)defining breast cancer survivorship as embodied space of “we”: How complementary and alternative medicine providers promote body acceptance

Post-stroke hemiparesis is the most common complication following stroke. Due to unsatisfactory results from conventional treatment, alternative treatments including homeopathy are increasingly becoming popular. Curare is the one of the recommended homeopathic medicine prescribed on ‘common symptoms’ of motor paralysis, but has not been researched systematically. We hypothesized that Curare 30CH would be non-inferior to individualized homeopathy (IH) in treatment of post-stroke hemiparesis in the context of standard physiotherapy.An open, randomized (1:1), exploratory, two parallel arms, pragmatic, non-inferiority, pilot trial was conducted at the Homoeopathic Materia Medica out-patient departments of National Institute of Homoeopathy (NIH), India on 50 patients comparing the effectiveness of Curare 30CH against IH. Comparative analysis was carried out on the primary outcome to detect non-inferiority by one-tailed t test at alpha = 5% with a prefixed margin (Δ) of 1.0 based on assumption. Oxford muscle strength grading scale and stroke impact scale (SIS) questionnaires were the primary and secondary outcomes respectively; assessed at baseline, after 3 and 6 months of treatment.Five subjects dropped out (Curare: 3, IH: 2). Groups were comparable at baseline (all P > 0.01). In both groups, both the outcomes improved significantly after 3 and 6 months. Non-inferiority was demonstrated by Curare 30CH against IH, both over 3 months (mean difference = 0.04, lower 95% confidence limit −0.195, t = 7.429, P < 0.001) and 6 months (mean difference = −0.2, lower 95% confidence limit −0.474, t = 4.899, P < 0.001). No adverse events were reported from either group.Both therapies seemed to produce comparable effects, and appeared as safe, still, being a pilot trial, no definite conclusion could be drawn. Further exploration of both efficacy and effectiveness of either of the therapies is necessary by adequately powered trials and independent replications.

Utilization of complementary and alternative medicine and conventional medicine for headache or migraine during pregnancy: A cross-sectional survey of 1,835 pregnant women

ObjectivesLittle is known about women’s use of health services affected by headache or migraine during pregnancy. This paper directly addresses the research gap reporting on the healthcare utilization among Australian pregnant women experiencing headache or migraine. Design and settingIn this retrospective observational study, data on 1,835 Australian pregnant women were obtained from the nationally-representative Australian Longitudinal Study on Women’s Health. Information on quality of life and health seeking behaviors regarding conventional medicine and complementary and alternative medicine providers was identified among these participants. Factors associated with healthcare use were analyzed using regression analyses. ResultsA total of 16% of the pregnant women surveyed experienced headache or migraine, and over 20% sought help from more than two types of healthcare practitioners for their headache or migraine. General practitioners (37.8%) were the most commonly consulted providers of pregnant women for their headache or migraine. Women with headache or migraine during pregnancy had worse health-related quality of life than those without. Education level and private health insurance status of pregnant women are the predictors of the use of healthcare practitioners for their management of headache or migraine (both p < 0.05). ConclusionsHeadache or migraine during pregnancy significantly impacts upon pregnant women’s quality of life. The use of multiple healthcare practitioners, including conventional medicine and complementary and alternative medicine practitioners, highlights the need for further research investigating health services utilization of pregnant women with headache or migraine in different severity and frequency to help inform effective and safe treatment.

Treating People with Arthritis with Traditional Chinese Medicine (Tcm): An Examination of the Perception of Tcm Practitioners

Emerging evidence has shown that traditional Chinese medicine (TCM) has a positive effect on arthritis. This research provides the first critical, systematic examination of TCM practitioners' perceptions of TCM use for people with arthritis. An online survey was distributed to all TCM professionals including acupuncturists and Chinese herbal medicine practitioners registered with the Practitioner Research and Collaborate Initiative (PRACI) practitioner database. The survey questions focus on practitioner characteristics, practice characteristics and clinical management approaches regarding arthritis care. The survey attracted a response rate of 53% (n=52). The average age of the respondents was 49.9 years, more than half were female, and the majority held a bachelor degree or higher qualification. More than two thirds of TCM practitioners in our study worked with other health professionals, while they had a high level of referral relationships with a wide range of conventional, allied health and complementary and alternative medicine (CAM) providers. Most of the TCM practitioners reported that their patients with arthritis used other treatments alongside TCM and a large number of the TCM practitioners who participated believed that TCM was effective for treating arthritis. The TCM profession represents a substantial component of the healthcare field in Australia, and treating patients with arthritis appears to be an important area of TCM practice, among others. Further detailed research is needed to help ensure effective, safe patient care for those with arthritis who may be utilising TCM alongside a broader range of conventional medicine, allied health, and other CAM treatments.