Alternative Medicine Usage Research Articles

Prevalence of complementary and alternative medicine use in Brazil: results of the National Health Survey, 2019

BackgroundIn recent decades, it has been possible to observe an increase in Complementary and Alternative Medicine (CAM) usage globally for both disease prevention and health promotion purposes. we aim to estimate the prevalence of CAM use and analyze associated factors in Brazil.MethodsObservational study with data from the 2019 National Health Survey that evaluated a sample of Brazilian adults. The outcome was CAM use, such as acupuncture, homeopathy, medicinal plants and herbal medicines, meditation, and yoga in the last 12 months. A logistic regression model with a 99% confidence interval was used to assess factors associated with CAM use.ResultsThe prevalence of CAM use in 2019 was 5.2% (CI99% = 4.8–5.6%), the most used modalities: medicinal plants and herbal medicines, with a prevalence of 3.0% (CI99% = 2.7–3.33) followed by: acupuncture 1.4% (CI99% = 1.3–1.6) homeopathy 0.9% (CI99% = 0.7–1.0), meditation 0.7% (CI99% = 0.6–0.8) and yoga 0.4% (CI99% = 0.4–0.5). We observed important geographical differences in CAM use in Brazil, with a higher prevalence in the North Region, 3.7% (CI99% = 2.81–4.75), where herbal medicines were more frequent the in the other regions. After estimating an adjusted model, women, older people, and people with a higher level of education and per capita income were the ones who used all types of CAM the most. The practice of yoga stands out among women 3.6% (CI99% = 2.49–5.28) and among individuals with higher per capita income 7.5% (CI99% = 2.97–18.93); meditation among individuals with higher educational level 13.4% (CI99% = 6.41–28.33) and acupuncture for those who declared regular or poor health 1.9% (CI99% = 1.51–2.39).ConclusionsWe recommend that the Ministry of Health expand CAM access to Unified Health System users and promote health professionals’ conscious and guided use for the Brazilian population.

Use and Attitudes of Complementary and Alternative Medicines Among Allied Health Sciences Students, University of Peradeniya

Background: Complementary and Alternative Medicine (CAM) consists of a group of medical and health care systems, practices, and products delivered outside the mainstream health care system. CAM treatments can be used not only to treat diseases but also to promote wellness, disease prevention, and manage symptoms. However, someone’s attitudes toward health may contribute to seeking CAM treatments. This study aimed to investigate the use and attitudes of CAM among Allied Health Sciences (AHS) students at the University of Peradeniya.Methods: An online questionnaire was used and all AHS students at the University of Peradeniya were invited to participate. The questionnaire comprised three parts: Part A) demographic data, Part B) usage of complementary and alternative medicines and Part C) attitudes toward complementary and alternative medicines. CAM usage and attitude differences between different degree programs and academic years were compared.Results: Of the 601 students invited, 314 (52.2%) responded to the questionnaire. Among them, 143 participants (45.5%) had used CAM during the past 12 months. Of them, vitamins were the most used CAM. Most participants (70.1%) had used CAM to improve their health, while (68.5%) had selected CAM to reduce side effects. More than one-third of students showed positive attitudes towards CAM. There were significant differences in CAM usage between students of pharmacy/nursing and MLS/Radiography/Physiotherapy, while there was no difference in attitudes regarding CAM. There were differences in attitudes concerning CAM between senior and junior students, however no difference in CAM usage.Conclusion: This study found that AHS students commonly reported using CAM. A comparison between Pharmacy/Nursing and MLS/Radiography/Physiotherapy students suggests that pharmacy/nursing education is associated with improved awareness and use of CAM among AHS undergraduate students in a Sri Lankan university.

Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean.

Users of complementary and alternative medicine (CAM) have a lower intention to receive vaccines. Furthermore, Latin America and the Caribbean (LAC) region are among the most affected areas by the COVID-19 pandemics and present a high proportion of CAM users. Therefore, this study evaluates the association between the consumption of herbal supplements or homeopathic remedies to prevent COVID-19 and the intention to vaccinate against COVID-19 in the LAC region. We conducted a secondary data analysis of a Massachusetts Institute of Technology (MIT) survey with Facebook to assess COVID-19 beliefs, behaviours, and norms. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated using generalized linear models of the Poisson family with the log link function. The prevalence of the use of products to prevent COVID-19 was the following: consumption of herbal supplements (7.2%), use of homeopathic remedies (4.8%), and consumption of garlic, ginger, and lemon (11.8%). An association was found between using herbal supplements (19.0% vs. 12.8%; aPR = 1.44; 95% CI: 1.30–1.58), the use of homeopathic remedies (20.3% vs. 12.3%; aPR = 1.58; 95% CI: 1.25–1.98), and the consumption of garlic, ginger, and lemon (18.9% vs. 11.9%; aPR = 1.55; 95% CI: 1.50–1.61) and non-intention to vaccinate against COVID-19. In the LAC population, there is an association between using herbal supplements, using homeopathic remedies and consuming garlic, ginger, and lemon to prevent infection by COVID-19 and non-intention to vaccinate against this disease. Therefore, it is necessary to design targeted strategies for groups that consume these products as preventive measures against COVID-19 to increase vaccination coverage and expand the information regarding transmission and prevention strategies for SARS-CoV-2.

Complementary and alternative medicine use and recommendations for discontinuation of supplements in an integrative oncology clinic.

12058 Background: It is well established that many patients with cancer are taking dietary supplements (DS) and alternative medicines and often do not disclose such to their care teams. There is potential for harm in several ways: 1) interactions with their medications that may increase side effects, 2) interactions with their treatment that may lead to decreased efficacy, 3) direct toxicity from the supplement 4) financial toxicity. We have recently started a new Integrative Oncology service to help counsel patients about improving lifestyle factors and assist patients with safe and evidence-based integrative treatments and supplements. Methods: Patient data (N=100) were collected prospectively from an Integrative Oncology Clinic. The number and type of DS were documented. Using the Natural Medicines Database (NMD), we determined whether supplements interacted with the patients’ other medications or cancer therapies. We calculated the percentage of patients in which a recommendation for discontinuation of DS was recommended, along with the supporting reasons. We calculated the most common DS being taken and other alternative therapies beyond supplements. Results: Ninety-one percent of patients took DS, with an average of 5.5 per patient (range 0-20). The most common DS patients reported taking (%): Vit D (52), Vit C (41), Multivitamin (34), probiotic (27), B Vitamins (26), Ca (20), zinc (20), fish oil (18), cannabis (18), mushrooms (18), turmeric (17), magnesium (15), melatonin (14), biotin (11), coq10 (7), iron (8), VIT E (5), and glucosamine (5). Eighty-nine percent of patients using DS were on active cancer therapy. In thirty-five percent of patients, we recommended stopping some of their DS or other therapies. Number of patients using alternative therapies beyond DS: IV Vitamin C (5), Rick Simpson oil (high dose THC) (4), extreme diets (4), mistletoe (2), re-purposed meds (2); and one each was using hyperbaric O2, ozone, homeopathic, ayurvedic, insulin-potentiated chemo, miracle mineral cure, chelation, low dose naltrexone Conclusions: Cancer patients both on and off active treatment are using large numbers of DS with potential for adverse effects and/or decreasing efficacy of treatments. This study highlights the prevalence of DS and alternative medicine usage in cancer patients referred to an integrative oncology clinic and demonstrates the need for counseling about safe supplement use; in 35% of patients, discontinuation of DS was recommended. [Table: see text]

Usage of Traditional, Complementary and Alternative Medicine and Related Factors among Patients Receiving Healthcare in Lesotho

Background: The use of Traditional, Complementary and Alternative Medicine (TCAM) is becoming apparent among many populations, particularly those suffering from chronic illnesses. Although this is a concern to clinicians, especially on safety and potential health risks, there is a paucity of data on TCAM usage and related factors among patients receiving healthcare in Lesotho. Objective: To determine the prevalence of TCAM usage and associated factors among patients receiving healthcare in a health facility in Lesotho. Methods: A cross-sectional study was conducted among 336 patients receiving healthcare in the Maseru district, Lesotho. A validated questionnaire was used to collect data on demographic and lifestyle factors, disease and treatment profile, treatment challenges, and TCAM usage, reasons/purpose, disclosure, healing system, duration, costs, sources and types. Multiple logistic regression analysis was used to ascertain any relationships with TCAM usage. Results: The response rate was 98%. The mean age of participants was 51±16years. Unemployment (63%) was high and, over half of the patients (59%) attained primary school education. Patients were mostly on treatment for sexually transmitted infections (42%), non-communicable diseases (30%) and comorbidities (19%), with 98% taking prescribed medication. TCAM usage was 15% with Traditional Herbal Medicine (THM) being the most widely used. Common THM were Dicoma Anomala, Eriocephalus Punctulatus, Aloiampelos Striatula, Artemisia Afra and Allium Sativum, obtained from the traditional healers (53%), followed by relative/friends (16%), pharmacists (13%), open market (12%), and accessed at low costs. TCAM was used to treat infectious (23%) and non-infectious (77%) diseases, but disclosure (7%) to healthcare workers was low. Multivariate analysis showed that TCAM usage was associated with self-employment AOR=6.3, 95%CI; 2.57-15.21, and being a student AOR=3.6, 95%CI; 0.99–12.71. Conclusion: THM was the most widespread type of TCAM among the study population in Lesotho. Prospective studies on TCAM usage are necessary to inform proper practice and safety in Lesotho.

KNOWLEDGE AND PRACTICE OF ALTERNATIVE MEDICINE FOR COVID 19 AMONG NURSES IN PUDUCHERRY, INDIA

Background: Development of alternative medicine usage makes it necessary for nurses to be up to date about these treatments. However, much information is needed about the level of knowledge and practice of the nurses in this field.
 Aim: The current study aimed to identify the level of knowledge and practice on selected alternative medicine for covid 19 among covid 19 positive nurses in Puducherry city, India.
 Subjects and Methods: A descriptive study was conducted among COVID 19 positive nurses, in Puducherry. Sample size were 55, selected through convenient sampling. The quantitative approach was used and design was descriptive survey design. Data collected by using structured questionnaire related to demographic variables and knowledge level. practice was assessed by Likert scale.
 Result: A total of 55 participants were recruited, majority of whom were female 42 (76.4%), and 44(80%) participants were aged between 18-30 years. The result shows that 39(70.9%)had heard about the alternative medicine and 33(60%) had not underwent any type of alternative medicine. The data show that 23(41.8%) had inadequate and moderate knowledge and 9(16.4%) had adequate knowledge, However,44(80%) had moderate practice and 5(9.1%) had adequate practice.
 Conclusion: These study findings revealed that majority of nurses were aware about the alternative medicine practiced in the region. when the level of knowledge of selected alternative medicine for covid 19 increases their practice also will be increased.

Use of complementary and alternative medicine among adult with epilepsy - experiences from a single epilepsy center in Malaysia

Complementary and alternative medicine (CAM) usage were reported in Europe, the United States of America and monoethnic Asian countries such as Korea and Taiwan. However, limited literature is available on the variability of CAM usage patterns among people with epilepsy (PWE) in a multi-racial country in particular Malaysia. This cross-sectional study assessed the prevalence, types, predictors and impact of CAM use among adult PWE and their adherence to anti-epileptic drugs (AEDs) treatment.140 patients were recruited, with a median age of 37.5 (IQR,28.0-51.5) years, majority female, had secondary or lower education level, earn <USD1077 and seizure frequency of <1 per month. One quarter (25.7%) used CAM for seizure control, of which 94.4% adhered to AEDs treatment while on CAM. Common CAM used were prayers, traditional herbal remedies, massage, and acupuncture. Only 33.3% have discussed CAM usage with their physician. The main reason for CAM usage was patients’ willingness to try other alternatives for seizure control. Although most patients had not used CAM, 20.2% were receptive to using CAM as concomitant treatment. Buddhists were more open to CAM while Muslims uses CAM selectively and avoid amulets, acupuncture, chiropractic, Ayurveda, yoga, and reiki. Logistic regression analysis showed Buddhist’s religion (OR,11.01), Muslims (OR,4.04), ≥1 seizure per month (OR,3.85) and monthly income of ≥USD1077 (OR,2.92) as the predictors for CMA usage. CAM use is common in Malaysia, especially among Buddhists and Muslims, with higher socio-economic status, and uncontrolled seizures. CAM is mostly used to complement but not in replacement of AEDs.

Complementary and Alternative Medicine Usage and Yoga Practice in Patients with Metastatic Breast Cancer

Metastatic breast cancer has a poor prognosis, and many patients practice yoga or use other complementary and alternative medicine (CAM) in their healthcare. CAM has risks and benefits, and it will be useful to understand the role of CAM integrated with conventional treatments such as chemotherapy and radiation. Patients with metastatic cancer may respond differently to CAM than those without metastases, and less literature has addressed disease progression in this regard. This short review will attempt to address CAM usage in patients with breast cancer, focused on metastatic disease. The review will address some geographical and cultural differences in CAM usage, benefits of yoga for this patient population to improve quality of life, and highlight study limitations and implementation.

Patient activation, self-efficacy and usage of complementary and alternative medicine in cancer patients

Complementary and alternative medicine (CAM) is used by many cancer patients by themselves. Therefore, we conducted a survey regarding the association between CAM, self-efficacy, and patient activation in adult cancer patients. A standardized questionnaire, consisted of the ASKU, the PAM 13-D, and a structured questionnaire on CAM usage from our own working group, was distributed to 880 potential participants. Six hundred and thirty-nine (639) patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% of all patients used CAM in the last 3 months (biological 73%, holistic 63%, mind–body methods 62%). Higher self-efficacy was associated with higher interest in CAM (p = 0.03), but not usage of CAM, compared to patients with lower self-efficacy (p = 0.099). Higher patient activation was associated with higher interest in CAM (p = 0.004) and usage of CAM (p = 0.012). Patients with higher activation significantly more often used homeopathy (p = 0.007), prayer (p = 0.002), yoga, etc. (p = 0.032), meditation (p = 0.002), low carb or ketogenic diets (p < 0.001) (but not vegan or other cancer diets). Higher patient activation is associated with higher usage of CAM. Focusing on patient activation as a goal in patient–physician relationship will help patients to adhere to a healthy lifestyle and to actively participate in the whole treatment process.

Usage of complementary and alternative medicine in older adults: prevalence, subtypes and associated factors; a cross-sectional observation

Usage of complementary and alternative medicine in older adults: prevalence, subtypes and associated factors; a cross-sectional observation

Perception of integrating complementary and alternative medicine practice in patient's treatment among the healthcare practitioners: a systematic review

There is a growing trend in complementary and alternative medicine (CAM) usage among the population with medical conditions. However, there is hesitancy for medical practitioners to integrate its application with the current treatment modality, despite governance by the authority. Hence, our objective is to systematically evaluate the healthcare perception towards integrating CAM in their practices. We systematically searched three large and renowned databases i.e., Scopus, Web of Science and PubMed, regarding "Perception on Integrating CAM Usage in Patient's Treatment among Healthcare Practitioners" from 2016 until 2020. At least two independent reviewers comprehensively screened and extracted the data from the accepted articles. A total of 15 studies were included in the final qualitative synthesis following a strict and rigorous assessment checked using MMAT 2018 checklist. The studies included providing the richness of information due to the qualitative nature of the study design. There were three main domains extracted i.e. knowledge, attitude, and perspective of the healthcare practitioner towards CAM integration. Limited knowledge of CAM among healthcare providers may be the possible main reason for non-supportive attitude and negative perspective on CAM. However, those who showed an inclination towards CAM were found to be more open and ready to learn about CAM if it provides benefits to the patients. There is a heterogeneity of perception towards CAM integration from healthcare providers' point of view. A proactive and systematic CAM literacy awareness program may help to improve their understanding and possibly gain more trust in its application.

Complementary and alternative medicine as preferable management of epilepsy among the population of Makkah City: a cross-sectional study

Background: Complementary and alternative medicine (CAM) usage is widespread. Epilepsy patients may believe in administering CAM as a therapy. However, evidence-based data about frequency, types, and drivers for CAM use are scarce. This study aimed at evaluating CAM as preferable management of epilepsy among the population of Makkah City. Methods: A cross-sectional observational study conducted In Makkah, involving adult patients aged &amp;ge;18 years diagnosed with epilepsy using a survey questionnaire for 10 months in 2021. Results: Out of the screened patients, a total of 131 patients fulfilled inclusion criteria, (100%) agreed to participate in the study with a mean age (±SD) of 31.4 ± 12.3 years, and 76 (58%) patients were males. About 56.5% of the patients tried using any type of CAM. The most commonly used CAM types were religious healers (78.4%), followed by herbal (56.8%), cupping (33.8%), and acupuncture (33.8%). 52.7% reported that they had no benefit. In comparison, 28.4% reported feeling better and more relaxed, 17.6% experienced staying positive, 12.2% of patients had reduced symptoms or side effects, and 9.5% had more feeling of being in control. Most patients (86.5%) had no complications from CAM. No significant predictive factors were detected for the use of CAM as regards age, gender, education, employment, seizure frequency, and duration, in addition to a family history of epilepsy or usage or compliance to antiepileptic drugs. Conclusion: Almost half of the people with epilepsy used CAM, mainly through religious healers or herbal medicine. Half of them reported no benefit from CAM usage. Most of them had no complications.

Complementary and alternative medicine usage amongst multiple sclerosis patients in Iran

Objectives: The aim of this study was to determine the prevalence and patterns of complementary and alternative medicine (CAM) usage amongst multiple sclerosis (MS) patients in Iran and to evaluate the perceived effectiveness. Methods: This was a descriptive cross-sectional study. Data were collected from 194 patients with MS at the neurology clinics affiliated with Shiraz University of Medical Sciences by a semi-structured questionnaire. Results: The prevalence of CAM usage was 67.9%. Herbal medicine was the most common CAM used among the patients (64.2%). Cupping therapy, relaxation therapies, acupuncture, leech therapy were the other common CAM modalities used. Although less commonly used, yoga had the highest perceived effectiveness. Conclusions: Due to the high prevalence of CAM usage, physicians should inform their patients about the advantages and disadvantages of CAM so as to help the patients make an informed choice.

A Comparison of Alternative Medicine Users and Non-Users in Patients With Hidradenitis Suppurativa.

Hidradenitis suppurativa patients often seek non-prescription therapies. To determine the prevalence of alternative medicine use and characterize the differences between patients who report using alternative medications versus those who do not. We surveyed 67 patients with hidradenitis suppurativa regarding demographics, alternative medicine use, disease severity, and quality of life. 25 (37.2%) of the HS subjects reported alternative medicine use. Alternative medicine users tended to be younger (36.7 vs 40.8 years), have a shorter time since diagnosis (12.6 vs14.6 years), and reported worse quality of life (14.1 vs 11.0) than non-users. These differences were not statistically significant. Limitations included a small sample size. Alternative medicine use among patients with hidradenitis is common regardless of disease severity; even mild disease may drive patients to seek alternative treatment. J Drugs Dermatol. 2021;20(10):1072-1074. doi:10.36849/JDD.6046.

Prevalence and Pattern of Self-medication with Alternative Medicine: Treatment-switch Analysis in Oral Submucous Fibrosis Patients.

The aim of this study was to investigate prevalence and pattern of self-medication with alternative medicine (ALM) among oral submucous fibrosis (OSF) patients with emphasis on treatment-switch analysis. A total of 115 OSF patients were recruited and subjected to scientifically validated questionnaire. Two groups were identified: S-ALM: patients who have previously received modern medicinal treatment but switched to ALM; and DN-ALM: patients who started ALM from De Novo. A total of 37 (32.18%) patients reported use of the ALM at some point of time. Twenty-five (67.56%) switched to ALM, whereas 12 (32.43%) patients used ALM from De Novo. The pattern of switching to ALM in short period was significantly prevalent in patients with advanced stages (stage III and IV) as compared to early stages (stage I and II) of OSF. Clarified butter, glycerin, and honey were the most commonly used ALM in both the groups. The most common reasons for switching to ALM were the cost of treatment (32.00%), longer duration of medicinal treatment (24.00%) and ineffectiveness of the medications (24.00%). ALM usage is common in OSMF patients with significant percentage of patient switched from modern medicine to ALM. Therapeutic efficacy of ALM in OSF needs exploration in future.

Complementary and Alternative Medicine Usage and Its Determinant Factors Among Infertile Women: A Case of Iran

Aim: Some evidence shows an increased utilization of complementary and alternative medicine for infertility treatment, although little information is available to measure this phenomenon in infertile women. Hence, this study aimed to assess the application of Complementary and Alternative Medicine (CAM) techniques on infertile women. Materials and methods: This study was cross-sectional. Infertile women referred to the only center of infertility in Kerman, Iran were selected using convenience sampling. In total,144 participants were assessed. Data were collected using a twopart researcher-made questionnaire and they were analyzed using descriptive and analytical statistics [chi-square test and logistic regression] with SPSS version 18. Results: 56.3% of participants in the present study used at least one of the CAM methods in the past year.. The multivariate logistic regression showed a significant correlation only between education and CAM users/non-users. Conclusions: According to the results, almost one third of infertile women used CAM to treat their infertility indicating high prevalence of CAM usage among infertile women. Therefore, health care providers must pay more attention for infertility treatment to reduce the treatment interactions and increase the quality of care.Keywords: Complementary Therapies, Infertility, traditional medicine, women.

Complementary and Alternative Medicine Use among Gynaecological Cancer Patients in Enugu, South-East Nigeria

INTRODUCTION: The high cost and associated adverse effects of conventional therapy make the patients seek complementary and alternative medicine. Complementary and alternative medicine use may contribute to the delay the patients have before seeking orthodox care.&#x0D; &#x0D; OBJECTIVES: To determine the prevalence, pattern, factors responsible for complementary and alternative medicine use and if complementary and alternative medicine use causes delay in seeking orthodox care among gynaecological cancer patients in Enugu. &#x0D; &#x0D; MATERIAL &amp;amp; METHODS: A pretested, semi-structured interviewer-administered questionnaire -based cross-sectional survey of 396 eligible gynaecological cancer patients recruited from both University of Nigeria Teaching Hospital, Enugu and Enugu State University of Science and Technology Teaching Hospital, Enugu between January, 2018 and June, 2020. The data was analyzed using the statistical package for social sciences version 23 (IBM SPSS, Chicago, IL).&#x0D; &#x0D; RESULTS: The mean age of the respondents was 57.3 years and it ranged from 41 to 77 years. Cervical cancer (76%) was the most common type of gynaecological cancer. A total of 283(71.5%) of the respondents used complementary and alternative medicine. Herbs (65%) were the most common type of complementary and alternative medicine used. Majority (56.9%) of complementary and alternative medicine users rarely used it. A total of 178(62.8%) complementary and alternative medicine users presumed that it would cure them while 105 (37.1%) presumed that it would relieve the symptoms of their cancer. However, 197 (69.6%) complementary and alternative medicine users stated that there was no actual benefit from its use. The low educational status has a statistically significant influence on complementary and alternative medicine use among the respondents(P-value=&amp;lt;0.0001). Complementary and alternative medicine use had a significant influence on delay to seek orthodox care among the study participants (P-value=&amp;lt;0.0001). Majority (84.5%) of the doctors, caring for the patients, were not aware of the patients&amp;rsquo; use of complementary and alternative medicine.&#x0D; &#x0D; CONCLUSION: Complementary and alternative medicine use among gynaecological cancer patients is high in Enugu. It also delays their presentation for orthodox care. Female education and public sensitization on the effect of complementary and alternative medicine use is necessary to curb this trend.

Health-care providers’ views of menopause and its management: a qualitative study

Objective This study aimed to explore Australian health-care providers’ knowledge of menopause and its consequences, and their views about menopause-related health care. Methods This was a cross-sectional qualitative study of Australian general practitioners (GPs), gynecologists (GYs) and pharmacists (PHs). Recruitment was ultimately achieved through professional networks and cold calling. Results There were equal numbers of GPs, GYs and PHs, and equal numbers of males and females in each group. All participants demonstrated sound understanding of menopause and its consequences. A strong theme was recognition of high usage of complementary and alternative medicines (CAMs) by women for menopausal symptoms. Most participants highlighted lack of efficacy evidence for most CAMs, but the majority of GPs and PHs considered CAMs to ‘have a role’. Most supported menopausal hormone therapy (MHT) when symptoms impaired quality of life. Limitations to comprehensive care included knowledge gaps and lack of time. Conclusions Australian health-care providers appeared knowledgeable about menopause, but uncertain about its management. MHT prescription appeared limited to women with severe symptoms despite lifestyle modification and a trial of CAMs. The upskilling of clinicians providing care for women at midlife, with respect to the indications for and prescribing of MHT, urgently needs to be addressed.

Patterns of Usage of Complementary and Alternative Medicine Among Adults Visiting Health Care Centers in Mysuru, India: A Questionnaire-Based Survey.

The study intended to assess extent of complementary and alternative medicine use among patients visiting health care facilities in Mysuru, India, and factors influencing its choice. Prevalence of complementary and alternative medicine use was 33% and was not influenced by sociodemographic factors and individual health perceptions and habits.

Lifestyle changes during the first wave of the COVID-19 pandemic: a cross-sectional survey in the Netherlands

BackgroundDuring the Covid-19 pandemic the Dutch government implemented its so-called ‘intelligent lockdown’ in which people were urged to leave their homes as little as possible and work from home. This life changing event may have caused changes in lifestyle behaviour, an important factor in the onset and course of diseases. The overarching aim of this study is to determine life-style related changes during the first wave of the COVID-19 pandemic among a representative sample of the adult population in the Netherlands.MethodsLife-style related changes were studied among a random representative sample of the adult population in the Netherlands using an online survey conducted from 22 to 27 May 2020. Differences in COVID-19-related lifestyle changes between Complementary and Alternative Medicine (CAM) users and non-CAM users were determined. The survey included a modified version of the I-CAM-Q and 26 questions on lifestyle related measures, anxiety, and need for support to maintain lifestyle changes.Results1004 respondents were included in the study, aged between 18 and 88 years (50.7% females). Changes to a healthier lifestyle were observed in 19.3% of the population, mainly due to a change in diet habits, physical activity and relaxation, of whom 56.2% reported to be motivated to maintain this behaviour change in a post-COVID-19 era. Fewer respondents (12.3%) changed into an unhealthier lifestyle. Multivariable logistic regression analyses revealed that changing into a healthier lifestyle was positively associated with the variables ‘Worried/Anxious getting COVID-19’ (OR: 1.56, 95% C.I. 1.26–1.93), ‘CAM use’ (OR: 2.04, 95% C.I. 1.38–3.02) and ‘stress in relation to financial situation’ (OR: 1.89, 95% C.I. 1.30–2.74). ‘Age’ (OR 18–25: 1.00, OR 25–40: 0.55, 95% C.I. 0.31–0.96, OR 40–55:0.50 95% C.I. 0.28–0.87 OR 55+: 0.1095% C.I. 0.10–0.33), ‘stress in relation to health’ (OR: 2.52, 95% C.I. 1.64–3.86) and ‘stress in relation to the balance work and home’ (OR: 1.69, 95% C.I. 1.11–2.57) were found predicting the change into an unhealthier direction.ConclusionThese findings suggest that the coronavirus crisis resulted in a healthier lifestyle in one part and, to a lesser extent, in an unhealthier lifestyle in another part of the Dutch population. Further studies are warranted to see whether this behavioural change is maintained over time, and how different lifestyle factors can affect the susceptibility for and the course of COVID-19.