Alternative Medicine Usage Research Articles

The knowledge, attitude, practice and predictors of complementary and alternative medicine use among type 2 diabetes mellitus patients in Indonesia

ObjectiveThe prevalence of complementary and alternative medicine (CAM) usage among patients with type 2 diabetes mellitus (T2DM) in Indonesia is high. However, to date, little is known about why Indonesian T2DM patients choose CAM therapies, how their knowledge, attitude and practice (KAP) of CAM affects their choices, or how demographics correlate with patient choices. Therefore, this study aimed to investigate the KAP and predictors of CAM usage in T2DM patients in Indonesia. MethodsThis was an observational, cross-sectional study. Patients were interviewed using a questionnaire. Chi-square tests or Fisher’s exact tests were used to compare demographic and clinical data, as well as KAP assessments, between T2DM patients who use and do not use CAM. Multivariate logistic regression analyses were used to investigate predictors of CAM usage. ResultsA total of 628 T2DM patients were enrolled in the study. CAM therapies were used by 341 patients (54.3%). The most common therapies were herbs and spiritual healing, used by 100.0% and 68.3% of CAM-using patients, respectively. CAM therapies were frequently recommended by family members (91.5%), and CAM users had significantly more knowledge and more positive attitudes toward CAM therapies than nonusers. Among users, 66% said they would not follow their healthcare providers’ instructions to not use CAM therapies, and 69.5% said they would not disclose their plan to use CAM therapies with their healthcare provider. Neither demographic nor clinical characteristics were associated with CAM use. The factors that best predicted the use of CAM therapies were their availability and low cost (odds ratio [OR] = 4.59; 95% confidence interval [CI]: 3.01–7.01), the belief that CAM therapies were safe (OR = 2.04; 95% CI: 1.40–2.95), the belief that CAM therapies could help with diabetes control (OR = 1.75; 95% CI: 1.15–2.66), and the belief that CAM therapies could help maintain physical health (OR = 1.68; 95% CI: 1.13–2.49). ConclusionCAM therapy users were more knowledgeable and had more positive attitudes toward CAM, but most of them chose not to disclose their CAM use to their healthcare providers. CAM use in Indonesia was associated with its accessibility, affordability, safety and effectivity, but not with any demographic or clinical characteristics. This study provided new evidence and insights for nurses and physicians in Indonesia that will help to design educational programs about the safety and efficacy of CAM therapies.

Factors influencing the usage of complementary and alternative medicine by patients with cancer

IntroductionThe interest in CAM among cancer patients is constantly growing and about 50% already used CAM alongside cancer therapy. Little is known on the factors influencing patients' choice of type of CAM used. MethodsA questionnaire consisting of two validated instruments (the ASKU (Allgemeine Selbstwirksamkeit Kurzskala), the PAM 13-D (Patient Activation Measure) and the structured AKKOM questionnaire on CAM usage was distributed at a German university hospital. Results639 patients (male 32.9%, female 63.2%; gynecological cancer 41%, gastrointestinal 19.2%, urogenital 15.6%) took part. 60% had used CAM in the last 3 months (biological 73%, holistic 63%, mind-body-methods 62%). Participants up to 30 years preferred biologically (p = 0.001), while women with gynecological cancer favored holistic based methods (p < 0.0001). There was no association between patients' beliefs on cancer causes and the chosen CAM method. ConclusionImproving knowledge in patients on cancer etiology and treatments could facilitate the understanding of additional complementary treatments.

A comprehensive approach to complementary and alternative medicine usage among patients from a vascular department.

Use of complementary and alternative medicine (CAM) therapies had been described in patients with disabling, chronic and painful conditions; these characteristics define the majority of vascular surgery (VS) entities. A lack of disclosure about CAM use from patients has been universally cited and may impact effective patient-doctor communication. Our primary objective was to describe CAM use, modalities, perceived benefits, safety, and associated factors among adult patients attending a VS outpatient clinic; we additionally explored patient's attitudes about CAM disclosure with their primary vascular surgeon. This cross-sectional study invited 223 consecutive outpatients to an interview where the ICAM-Q (International Complementary and Alternative Medicine Questionnaire) and the PDRQ-9 (Patient-Doctor Relationship Questionnaire-9 items) were applied. In addition, sociodemographics, vascular disease and treatment-related information, comorbidity, and disease severity characteristics were obtained. Appropriated statistics was used; multiple logistic regression analysis identified factors associated to CAM use. All statistical tests were two-sided, and a p value ≤ 0.05 was considered significant. IRB approval was obtained. Patients recruited were primary females (69%) and had a median age of 65 years (54-75). Most frequent vascular diagnoses were chronic venous insufficiency (36.2%) and peripheral artery disease (26%). There were 104 (46.6%) patients who referred CAM use, primarily self-helped practices (96%), and use of herbal, vitamins, or homeopathic medicines (23.7%). Overall, the majority of the patients perceived CAM modalities helpful and 94.6% denied any adverse event. Female sex (OR: 1.768, 95% CI: 0.997-3.135, p = 0.051) and hospitalization during the previous year (OR: 3.173, 95% CI: 1.492-6.748, p = 0.003) were associated to CAM use. The majority of the patients (77%) agreed about CAM disclosure with their primary vascular surgeon; meanwhile, among CAM users, up to 54.9% did not disclose it, and their main reasons were "Doctor didn't ask" (32%) and "I consider it unnecessary" (16%). The patient-doctor relationship was rated by the patients with high scores. CAM use is frequent and perceived as safe and beneficial among VS outpatients; nonetheless, patients do not disclose CAM use with their primary vascular surgeons, and a wide range of reasons are given by the patients that prevent effective and open communication.

Medication adherence and complementary therapy usage in inflammatory bowel disease patients during the coronavirus disease 2019 pandemic.

Background and AimMedication nonadherence is common in patients with inflammatory bowel disease (IBD) and has been associated with worse outcomes. The coronavirus disease 2019 (COVID‐19) pandemic led to significant consumer and medical concern regarding the possible risks of immunosuppressive medications during the pandemic. This study aimed to examine medication adherence and complementary and alternative medicine (CAM) usage during the COVID‐19 pandemic.MethodsAn online survey was sent to patients from two tertiary IBD units. The survey included medication nonadherence attributed to the COVID‐19 pandemic, complementary therapy, and IBD medication use. Validated measures of IBD disease activity, medication adherence, and beliefs about medicines were obtained.ResultsOf 262 respondents (median age of 46, 58% female) 14 (5%) patients reported self‐initiated missed doses or dose reduction of IBD medications directly attributed to the COVID‐19 pandemic. Positive associations with medication nonadherence included current corticosteroid requirement (P = 0.022), higher disease activity scores (P = 0.026), and higher concern about medicines score (P = 0.04). CAM usage was common, aimed at treating mental health in most cases, and infrequently attributed to the COVID‐19 pandemic.ConclusionsEven in the setting of low COVID‐19 prevalence, the pandemic reduced IBD medication adherence in 1 in 20 patients. This reduced adherence was co‐associated with increased disease activity and corticosteroid use. Understanding the underlying beliefs driving suboptimal IBD medication adherence is critical to prevent avoidable adverse IBD outcomes.

Prevalence and predictors of the usage of complementary alternative medicine among infertile patients

PurposeThe primary objective of this study was to evaluate the prevalence, characteristics and the most frequently used complementary and alternative medicine (CAM) methods among infertile couples. A secondary aim was to assess predictors and patients’ attitude to disclose the usage of CAM. MethodsThis study was designed as a cross-sectional survey and conducted on patients admitted to infertility clinics of two hospitals. ResultsThe overall prevalence of CAM among 324 infertile participants (162 couples) was 25.6 % (n = 83). 48 % of the infertile couples had experience with at least one type of CAM method and the most commonly used CAM was herbal products (84 %). The frequency of CAM tended to be higher among females compared to males (33 % versus 17 %, respectively; p = 0.02). Patients who failed to conceive with previous medical therapies were more inclined to use CAM (p = 0.01). After logistic regression analyses, only gender and previous unsuccessful ART treatment were found to be associated independently with CAM use. ConclusionCAM use is common among infertile population. CAM users were more likely to be women at any age who had failed to achieve a pregnancy with previous artificial reproductive treatment(s), mainly used herbal products and mostly reluctant to report the use of CAM.

Utilization of Complementary and Alternative Medicine among Korean Elite Athletes: Current Status and Future Implications.

The objective of the study was to explore the status of usage of complementary and alternative medicine (CAM) among Korean elite athletes. A survey was emailed to all Korean national sports federations recognized by the International Olympic Committee and the Olympic Council of Asia. A total of 705 Korean elite athletes participated in this study. The athletes had to be any of the following to participate in this survey: elite intercollegiate athletes, professional athletes, and national team athletes. 83.3% of the participants stated that they have previously experienced Korean medicine (KM). Compared to the general population in Korea, athletes had more experience (general population = 73.8%). The participants without experience mentioned that they either did not need any KM treatments (39.8%) or lacked information (39.8%) regarding KM treatments. The primary reason for the utilization of KM was the effectiveness of treatments. Therefore, 70.8% of the participants have mentioned recommending KM to others. Generally, athletes are worrisome that the consumption of herbal medicine may not be doping-free; however, it is vital to note that 62% of the participants expressed that prescribed herbal medicine is safe. Overall, this research demonstrates a high prevalence of KM usage by intercollegiate, professional, and national team athletes in Korea. Hence, this study's results may serve as the foundation in future research directions for promoting KM among Korean elite athletes.

Complementary and alternative medicine for urinary tract illnesses: A cross-sectional survey in Jordan

The aim of this study was to assess the extent of Complementary and Alternative Medicine (CAM) usage, especially herbal preparations, in treating urinary tract illnesses, and their perceived efficacy. This was a cross-sectional survey that used a convenience sample of 278 adults who reported having any form of urinary tract illness. During the last 3 months, 105 (37.8%) of participants had used CAM for various urinary tract conditions, of which, 87 (82.9%) used herbal remedies. Urinary tract infections (UTIs) were the most reported urinary condition (n = 77, 73.3%) among CAM users. The most commonly used herbs were, parsley (n = 54, 19.2%), followed by chamomile (n = 29, 10.4%), barley (n = 20, 7.4%) and ginger (n = 18, 6.7%).The study provides an overview of various CAM remedies used to treat urinary tract illnesses in the Jordanian society, which would draw attention to the necessity of conducting interventional studies to evaluate the efficacy and safety of CAMs in treating urinary tract illnesses, either as stand-alone or adjuvant treatment.

Factors associated with low adherence to medications in heart failure

Background: Medical therapy is fundamental in the management of heart failure (HF), and it is associated with favorable outcomes. These outcomes are attainable with good adherence to medications. However, the level of adherence to HF medications and the associated factors have not been well documented in Nigeria.Aim: The aim of the study is to determine the level of adherence to HF medications and the associated factors in HF patients.Materials and Methods: This was a cross-sectional study of HF patients in a tertiary health facility. A researcher-administered questionnaire was used to obtain demographic variables, assess adherence to HF medications with the Morisky medication adherence (MA) scale, and determine barriers to adherence. The proportions of respondents with a high and low adherence were derived, and the associated factors were investigated with Chi-square tests and multiple logistic regression.Results: They were 168 respondents with a median age of 63 years, and 94 (56%) were females. The median MA score was 4.13. Forty eight (28.6%) and 120 (71.4%) had high and low MA, respectively. The associations of comorbidities, method of payment, and alternative medicines with the level of adherence gave p values of 0.000, 0.002, and 0.000, respectively. Barriers to adherence were financial 43 (35.8%), forgetfulness 38 (31.7), and others constituted 44 (36.7%).Conclusions: Adherence to HF medications is suboptimal. It is associated with out-of-pocket payment, comorbidities, and usage of alternative medicines. Financial constraint and forgetfulness are the common self-reported barriers to adherence. Interventions to address these factors should be initiated.

Evaluation of prescription practices in rheumatoid arthritis at the rheumatology clinic in a tertiary care teaching hospital in Uttarakhand: A cross-sectional study.

Objective:This study was aimed to analyze the prescription pattern of disease modifying anti-rheumatic drug (DMARD) therapy in patients with rheumatoid arthritis (RA) in a tertiary care teaching hospital in Uttarakhand, India.Methodology:This cross-sectional study was conducted in 150 RA patients who were given DMARD therapy. Patient's demographic details, drugs prescribed with their dosage and administration routes and the usage of complementary and alternative medicine (CAM) therapy were recorded to study the prescription pattern.Results:Overall, 4 DMARDs were prescribed in all the studied patients: Methotrexate (n = 150), hydroxychloroquine (n = 35), leflunomide (n = 5), and adalimumab (n = 1). Single DMARD therapy with methotrexate was prescribed to 110 (73.3%) followed by double therapy with methotrexate + hydroxychloroquine in 35 (23.3%), triple therapy (methotrexate + hydroxychloroquine + leflunomide) in 4 (2.7%) and triple therapy with biological DMARD (methotrexate + hydroxychloroquine + leflunomide + adalimumab) in 1 (0.7%) patient. Adjuvant therapy drugs included: Prednisolone (n = 150), folic acid (n = 150), naproxen (n = 150), calcium (n = 150), vitamin D (n = 150) and indomethacin (n = 40). Of the total, 61.4% patients also took complimentary alternative medicine (CAM) therapy.Conclusion:Our study concludes that the most commonly prescribed DMARDs in our setting, to patients of RA, in descending order of frequency were methotrexate, followed by hydroxychloroquine, leflunomide and lastly adalimumab. A total of five adjuvant medications were commonly prescribed to all patients. There was a high prevalence of self-medicated CAM therapy in the majority of these patients.

Study of awareness, attitude, and utilization of Complementary and Alternative Medicine among patients visiting urban and rural health centers

Worldwide there is a recent increase in the usage of Complementary and Alternative Medicine (CAM), which has been defined as a group of diverse medical and healthcare systems, practices and products that are presently not considered to be a part of conventional medicine. The objectives were to assess and to compare the awareness, perspective, and utilization of CAM among urban and rural patients. A cross-sectional study was conducted among 200 out-patients attending the urban and rural health centers with a standardized questionnaire. MS Excel and Epi Info were used for data entry and analysis. The awareness of CAM was 71% of urban patients and 63% of rural patients. Despite the awareness of CAM, the urban patient either liked CAM (32%) or apathetic towards CAM (32%) and rural patients mostly apathetic towards CAM (47%). Both areas of patients (41%) used CAM, of which 36% were urban patients and 46% were rural patients. There is a higher proportion of aware patients in rural areas (73%) used CAM when compared to the usage of CAM by aware patients in the urban area (51%). Despite the usage of CAM, both areas of patients preferred Allopathy. In summary, this study demonstrated that most patients are aware of CAM, but patients were mostly apathetic towards CAM. Around half of the patients utilized alternative medicine.

Complementary and alternative medicine usage in patients with Familial Mediterranean Fever

Complementary and alternative medicine usage in patients with Familial Mediterranean Fever

Complementary and Alternative Medicine Usage and Its Determinant Factors Among Infertile Men in Iran.

Objective: This study aimed to assess the use of some Complementary and Alternative Medicine (CAM) techniques in infertile men. Materials and methods: This cross-sectional study was conducted on 102 infertile men referred to the only center of infertility in Kerman, Iran using convenience sampling. Data were collected using a two-part researcher-made questionnaire and analyzed using descriptive and analytical statistics (chi-square test and logistic regression) with SPSS 16. Results: According to the present study, 72.5% of subjects used at least one of the CAM methods in the past year. Among them 28.4% of the subjects have used one CAM technique, 13.7% have used two techniques, 8.8% have used three techniques, 9.8% have used four techniques, and 11.8% have used more than four techniques since the last year. None of the socio-demographic characteristics had significant association with being the user of complementary and alternative medicines. Conclusion: The results showed that almost three quarters of the infertile men used CAM indicating a high prevalence of CAM usage among them.

Complementary and Alternative Medicine Use in Children with a Developmental Disability and Co-occurring Medical Conditions

ObjectiveThe primary aim of this study was to evaluate differences in the prevalence of complementary and alternative medicine (CAM) usage among children with and without developmental disabilities (DD). Secondarily, the association between CAM usage and comorbid chronic medical conditions was explored among children with DD. DesignData come from the 2012 Child Complementary and Alternative Medicine Supplement of the National Health Interview Survey, a nationally representative sample of children in the United States between the ages of 4 and 17 (n = 10,218).Main outcome measures Multiple logistical regression models provided insight into the relationships between parent-report CAM usage, DD, and chronic medical conditions. ResultsChildren with developmental disabilities were more likely to use CAMs compared to their typically developing peers (21% vs 16%). Children with DDs and comorbid chronic medical conditions used CAMs at even higher rates (23% vs 18%). ConclusionsResults indicated that children with DD, especially those with a co-occurring chronic medical condition, use CAMs more often that typically developing children. Given scarcity of information on safety and effectiveness, clinical providers need to be alert to which children may be more likely to be exposed to CAMs. Communication between parents and providers needs to include discussion of CAM treatments.

Knowledge, attitude, and practice of complementary and alternative medicine: a survey of Iranian nurses

Background Development of complementary and alternative medicine (CAM) usage makes it necessary for nurses to be up to date about these treatments. However, much information is needed about the level of knowledge, attitude and practice of nurses in this field. Aims The present study was conducted to determine the level of knowledge, attitude and practice of CAM in nurses working in Iranian hospitals. Methods It was a descriptive study. A researcher-made questionnaire was completed by nurses working in four hospitals. Descriptive statistics were used to analyse the data. Results Two hundred and thirty-three nurses completed the questionnaire (response rate = 83.8%). Most nurses had little knowledge of CAM. The most familiar methods were Nutrition, Massage Therapy and Herbal Medicine. Of the nurses, 71.1% believed that CAM would be effective in disease treatment, showing their positive attitude toward CAM; 1.56% of nurses used CAM, and most nurses did not use CAM in clinical settings. Conclusions Although nurses have a positive attitude toward CAM, their knowledge level is low. Regarding nurses’ role in patients’ treatment and the importance of their capability to treat, the need to increase nurses’ knowledge of CAM is felt, and its education should be included in the nursing curriculum.

Cluster Analysis to Characterize the Patterns of Complementary and Alternative Medicines Usage in Asthma Controls

Background: Clinicians and physicians need to be aware of the high prevalence of complementary and alternative medicines use in patients with asthma, as it is found to be associated with lack of asthma control, though the degree to which associations exist is still not clear. Methods: We have performed a cluster analysis to characterize patterns defining different asthma control levels and the extent to which the medicines have an impact in these categories. Results and Conclusion: We have explored the association of Complementary and Alternative medicines utilization with asthma control and the effect of asthma controller medications, with the conclusion that the usage of complementary and alternative medicines does not have a significant impact on partially and uncontrolled asthmatics.

Identifying profiles of complementary and alternative medicine believers and/or users

The present study focuses on the identification of profiles of CAM believers and/or users. Using data from the Spanish CIS Barometer (2018) and a sample of 2486 Spaniards, a hierarchical and non-hierarchical cluster analysis and discriminant analysis have been performed. Profiles of people with a high level of belief in CAM and/or CAM users were identified. Results reflect relationships between personal factors (healthy lifestyle and status, political and religious ideology) and satisfaction with conventional medicine with the belief/use of CAM. Personal factors and satisfaction are not related to the level of belief in CAM. We have tried to fulfil some gaps detected in the literature: much of the research has been methodologically limited and there is a need to deepen the study of factors and processes that favor the initial uptake and subsequent use of CAM. Doing this, this paper offers diverse recommendations for organizations worried about this theme.

Complementary and alternative medicine use for weight management among females in Jordan: a community-based survey.

The relationship between obesity and various chronic diseases is well documented. In Jordan, the prevalence of overweight (30.0%) and obesity (38.8%) among females is on the rise, encouraging many adults to rely on alternative health care methods to manage their weight. We explored the status of complementary and alternative medicine use for weight management among adult females in Jordan and the possible relationship between complementary and alternative medicine use and body mass index. An interviewer-administered, structured questionnaire was used to collect data on the use and safety of complementary and alternative medicine for weight management from 858 women in 2015. Responses were coded and analysed using SPSS, version 20. Around 40% of the respondents reported using some form of complementary and alternative medicine for weight management. Commercial dietary supplements (31.2%), herbal remedies (26.7%) and folk remedies (18.0%) were commonly used. Green tea and fibre tablets were the most widely used herbal supplements. Logistic regression analysis indicated that overweight participants are more frequent complementary and alternative medicine users compared to obese. Relatives and friends were the main sources of information about complementary and alternative medicine. Only 31.9% of women believed that complementary and alternative medicine modalities were safe; around half believed they were not safe during pregnancy (52.5%) and lactation (48.0%). Only 49.7% were aware of side-effects and 41.5% of drug interactions. This study revealed that complementary and alternative medicine is often used for weight management. Awareness of the safe use of complementary and alternative medicine with other medications and during pregnancy and lactation should be addressed.

Usage of Complementary Alternative Medicine among the Patients Attending Tertiary Care Hospital

Background: Complementary and alternative medicine (CAM) includes Ayruveda, Homeopathy, Unani,yoga and Naturopathy, and other traditional medicine.Aim and Objectives: The study was conducted to determine the prevalence of usage of CAM among thepatients attending tertiary care hospital.Methodology: It was observational study. 528 patients were included in to the study randomly from outpatientdepartment. Study instrument was a pre-designed, pre-tested,semi-structured schedule.Results: The prevalence of Complementary alternative Medicine usage was 22.3%. Homeopathy was usedmost commonly (59.3%) by the users. 10.2% of users were continuing the usage of CAM. Most commonindications for usage of CAM were musculo-skeletal problems (29.7%), allergies (23.7%).Conclusion: Around one-fourth of patients attending tertiary care hospital were using CAM. Patients optedfor CAM because of lesser side effects and more effective. Only few percent revealed to the doctors aboutthe usage of CAM.

The Impact of an Evidence-Based Education on Complementary and Alternative Medicine Usage in People with Cancer: Pilot Study.

Complementary and alternative medicine (CAM) usage amongst cancer patients is high globally and in Australia. CAM use in cancer care has the ability to increase chemotherapy toxicity or cause sub-therapy due to altered metabolism as well as increase a patient's bleeding risk. Furthering these risks, people with cancer are largely obtaining their CAM use information from non-evidence-based sources. This study aimed to determine whether the implementation of a CAM education influenced decision-making with regard to CAM usage amongst cancer patients. Twenty people with cancer were recruited for participation in this study. The aims of this study were achieved by surveying patients via questionnaire, both prior to and following receiving an evidence-based CAM education, in either or both written or audiovisual format. This exploratory study found, consistent with the literature, that the majority of participants were obtaining their CAM use information from non-evidenced-based sources. Additionally, it found that the participants wanted more CAM use information and that they demonstrated some altered decision-making after receiving evidenced-based information. On the post-educational questionnaire, the number of participants that stated that they would use CAMs decreased by almost 14%, and some participants made CAM use decisions in accordance with the information provided in the resources. Furthermore, a small increase in CAM knowledge was demonstrated, and it was reported that the resource had prompted them to look further into CAM information. Lastly, the participants in this study found the resource to be mostly useful and helpful and preferred the animated video to the written information.

Usage of complementary and alternative medicine in women with urinary incontinence at a hospital in Turkey

BackgroundUrinary incontinence (UI) is a health problem that is common in women of all ages. Besides pharmacological and surgical treatments, there are lifestyle changes and complementary and alternative medicine (CAM) to relieve UI symptoms. This study aimed to examine lifestyle arrangements and CAM use by women with UI. MethodsWe conducted a cross-sectional study using data from 352 women with UI. The study sample consisted of female patients that were aged 18 and above. We asked patients whether they experienced urine leakage, and included all patients with UI in the sample regardless of UI type or severity. We collected the study data by using the personal information form and Incontinence Severity Index (ISI). ResultsIn this study, 7.1% of women with UI used CAM while 92.9% did not. We found that only the women with mixed incontinence used CAM more (p < 0.05). The CAM techniques commonly preferred by women included prayer (48.0%), hot application (36.0%) and herbal teas (24%). While 52.2% of women stated that they benefited from CAM use, all of them (100%) stated that they experienced no side effects of CAM. The most common lifestyle changes was losing weight. ConclusionTurkish women with UI had a low rate of CAM use in this study. The use of CAM was related to age and education, and women with mixed UI used CAM more.