Complementary And Alternative Medicine Categories Research Articles

Asian-Origin Complementary and Alternative Medicine Perceptions Among Undergraduate Medical Students: A Cross Sectional Study

Complementary and alternative medicine (CAM) is an important feature of patient medical history. This study sought to investigate the perceptions of medical students at Touro College of Osteopathic Medicine in Harlem, New York (TouroCOM-NY) regarding Asian-origin CAM practices. An anonymous survey was distributed to first and second year TouroCOM-NY medical students, asking about their familiarity with, and general attitude towards, five categories of Asian-origin CAM (acupuncture, reiki, tai chi, Ayurveda, and use of non-mineral/vitamin substances) 107 students responded from the first-and second-year class at TouroCOM-NY in 2018, with an 84% response rate. Demographics were equally distributed between genders and were predominantly of Asian or Caucasian origin (mirroring that of the institution). 59% indicated no knowledge of 2 or more of the CAM practices listed; 41% indicated no knowledge of 3 or more. Only 20% indicated practice of at least one of the listed CAM and noted strong familiarity. This survey demonstrated significant knowledge gaps and attitudes for Asian-origin CAM practices that can be addressed by curriculum change in undergraduate medical education.

The use of complementary and alternative medicine by adults with allergies: a Czech national representative survey

BackgroundThe prevalence rates of the use of Complementary and Alternative Medicine (CAM) in allergy patients range from 42% in the United States up to 50% in Europe. In the Czech Republic, no such data exists. Our aim was to examine patterns in CAM use in populations with self-reported allergies in the Czech Republic.MethodsA cross-sectional survey was conducted. A sample of citizens aged 15 years and older, sex, age, and region-stratified, was randomly selected from the 2014 voter registration lists (n = 8,395,132). Respondents with self-reported allergies were further analyzed.ResultsOverall, 93% of the respondents with self-reported allergies reported the use of 1 or more CAM modalities during the past 30 days. Herbal teas, relaxation techniques, a detoxifying diet, dietary supplements (excluding vitamins and minerals), and reflexology were used in respondents with allergies. Females, under age 30, with higher education, higher income, and self-reported poor health, were significantly associated with the use of CAM among respondents with allergies.ConclusionsThe prevalence of CAM use among people with self-reported allergies in the Czech Republic is higher compared to other countries, with determinants of CAM varying across specific CAM categories. More attention to existing use is needed to promote the healthy adoption of CAM by raising awareness of its safe and effective use, both for CAM users as well as for health care providers.

Provision of complementary and alternative medicine: Compliance with the health professional requirements

BackgroundDespite an increased prevalence of complementary and alternative medicine (CAM), its regulation varies from country to country, and no common approach has been adopted. A comprehensive overview is currently lacking of the ways the CAM therapies are regulated based on the criteria derived from the regulations relevant to particular medical professions. MethodsThe level of regulation of 100 most commonly used CAM modalities was evaluated according to the criteria based on the requirements for health professionals. A maximum of 10 points were obtainable. Internet searches were conducted from December 2016 to April 2017. ResultsSeventy-two of a total of 98 CAM modalities were selected and evaluated according to the predefined criteria. More than 50 % of criteria were met by 29 % of the CAM modalities. One of the most frequently met criteria was compliance with the requirements for professional practice, and the least often met criterion was registration obligation with a professional organization. The highest average score of 5.6 was received by the CAM category biologically based therapies. The lowest average score of one point was obtained by energy-based medicine. ConclusionThere is a lack of monitoring and regulating of CAM providers and monitoring the safety of CAM practices based on criteria for health care providers. Professional regulatory guidance is required to ensure the safety and quality of CAM therapies.

Complementary and Alternative Medicine in Chronic Rhinosinusitis: A Systematic Review and Qualitative Analysis.

Complementary and alternative medicine (CAM) is frequently used in the treatment of chronic rhinosinusitis (CRS) in developed countries. With a plethora of CAM therapies available, their effectiveness and safety are poorly understood in the context of CRS. This article aims to critically appraise the evidence for CAM use in CRS through a systematic review of current literature that investigate the effects of CAM on symptoms and clinical status of adults with CRS. Systematic review and qualitative analysis. A comprehensive systematic review of the literature was conducted by the authors using 5 databases from inception to July 2017: CINAHL, Cochrane, Embase, PubMed, and SCOPUS. Inclusive medical subject headings and keywords consisted of, but were not limited to, sinusitis and complementary therapies, naturopathy, or traditional Chinese medicine. PRISMA guideline was followed. Using templates by Cochrane Public Health Group and Newcastle-Ottawa Scale, each author extracted data, assessed bias, and computed minimal clinically important difference. Any conflicts were resolved through discussion. In total, 7 of 7141 articles from 1995 to 2016 were included. Three randomized controlled trials and 4 observational studies were organized into 4 categories of CAM: naturopathy, Chinese medicine, homeopathy, and others. Limited evidence supported the use of Pimpinella anisum and crenotherapy for CRS. Data available on Chinese medicine, homeopathy, and liposomal therapy in CRS were inconclusive due to inherent flaws in the studies. Overall, there is very limited evidence to support the use of CAM in the treatment of CRS. No significant adverse effects have been found. Given its widespread use, more rigorous data from high-quality research are needed before it can be routinely recommended.

Complementary and alternative medicine (CAM) practices and dietary patterns in children with inflammatory bowel disease in Singapore and Malaysia

BackgroundThe use of complementary and alternative medicine (CAM) has been associated with adverse effects and self-imposed dietary restrictions. The prevalence of its use in Asian children with inflammatory bowel disease (IBD) is unknown. We aimed to determine the prevalence, types, and factors associated with the use of CAM among children with IBD from Singapore and Malaysia, and to ascertain if dietary restriction was prevalent in patients who used CAM. MethodsA cross-sectional study was conducted in which parents of children with IBD attending two tertiary pediatric IBD referral centres in Singapore and Malaysia were interviewed. Data about demographics, conventional treatment, complementary therapies and dietary patterns were collected in a questionnaire. ResultsOf 64 children with IBD interviewed, 83% (n = 53) reported the use of CAM (Singapore [90%] vs. Malaysia [76%]; p = 0.152). The median number of CAM agents used was two (range 1–10). The three most common types of CAM used were probiotics (64%), vitamin and mineral supplements (55%), and food-based therapies (36%). Among individual CAM categories, the use of food-based therapies was correlated significantly with nationality (r = 0.497, p < 0.001), history of weight loss due to IBD (r = 0.340, p = 0.013) and avoidance of certain foods to prevent a relapse (r = 0.289, p = 0.036). Parents who rated their child's disease activity as more severe were less likely to use CAM (r = −0.257, p = 0.041). Fifty-nine percent of CAM users reported physician awareness of their CAM use. The overall self-perceived efficacy of CAM in improving IBD symptoms was 34%. Of the dietary patterns explored, only intake of dairy products was associated with CAM use (r = 0.306, p = 0.019). ConclusionUse of CAM is prevalent in children with IBD in Malaysia and Singapore. Further studies to elucidate reasons influencing CAM use, dietary patterns and efficacy of commonly used CAM would be required.

Complementary and Alternative Medicine Use Among Patients With Cancer

Numerous large trials involving more than 100000 patients have documented that adjuvant chemotherapy (AC) leads to considerable reductions inbreastcancer–relatedmortality.1Despite the well-documented survival benefits, a proportion of women for whom AC is indicated may delay or completely fail to initiateAC.This is a cause for considerable concern, as supported by the results of a systematic reviewandmeta-analysis of 7 studies involvingmore than34000women treated surgically for breast cancer, indicating that overall and disease-free survival is reduced by 15% and 16%, respectively, for every 4-week delay in initiation of AC.2 It is therefore of urgent interest to determine the factors associatedwith noninitiation of AC.With respect to patient decisions to delay or ultimately reject AC all together, a complex interaction of sociodemographic, clinical, and psychosocial patient characteristics, as well as oncologist factors, are likely to be at play. In this issueof JAMAOncology, Greenlee et al3 explore the possible role of patients’ use of complementary and alternative medicine (CAM) in noninitiation of AC in a cohort of 685 women with nonmetastatic, invasive breast cancer. Selfreport data collected 12 months after baseline indicated that 11%of thewomen forwhomACwas indicatedaccording toNational ComprehensiveCancerNetwork guidelines didnot initiate AC. A considerable proportion of the participants (87%) reported use of 1 or several types of CAM, and, after adjusting for anumberofdemographic andclinical variables, thehigher thenumberofCAMmodalitiesused, themore likely thewomen were tohavenoninitiatedAC.Amongthestrengthsof thestudy is that not only did the authors prospectively investigate the associationofoverallCAMusewithnoninitiation,but theyalso explored the use of several CAMmodalities. Users of dietary supplements seemed to be particularly at risk of not initiatingAC,whereas use of variousmind-bodypractices (eg, yoga, meditation, and acupuncture) seemed to be unrelated to AC initiation. Greenlee and colleagues3 did not explore patients’ motivations or their perceptions of CAM efficacy, but they do discuss the possibility that the benefits patients hope to obtain differ between these 2 categories of CAM. This finds support in a study4 of CAM use in a nationwide prospective cohort of 3343 Danish women treated for primary breast cancer. A considerable proportion of CAM users (23.7%) were absolutely or relatively certain that the CAM used would have a beneficial effect on their breast cancer, and, when exploring differences between use of various types of CAM, women who used herbal medicines or dietary and/or exercise counseling emerged as more likely than women who used various mind-body practices to perceive the CAM used as effective in treating their cancer. It thus seems quite possible that similar differences in perceived efficacy could explain the findings of the Greenlee et al3 study that users of dietary supplements were less likely to initiate AC and underscores the necessity to investigate the various characteristics associated with use of different CAM modalities rather than treating CAM use as one homogenous category. Additional findings from the cohort of Danish women treated for breast cancer could indicate that this particular groupofCAMusersmaybeparticularly vulnerable.5 TheCAM users thus reported more depressive symptoms than nonusers at both 3 and 15 months after surgery, with further analyses showing that having used CAM during the 12-month follow-upperiodwas associatedwithhigher levels of depressive symptoms at follow-up, even after adjusting for baseline depressive symptoms and sociodemographic, disease-related, and treatment-related variables, including comorbidity and previous psychiatric history.When comparing different CAM modalities, theuseofdietarysupplementsemergedas theonly independentpredictorof experiencingmoredepressive symptoms at both time points. The results described by Greenlee et al3 and others emphasize theneedto improveourunderstandingof thedecisionmaking process of patientswith cancer in their choice of conventionaloralternativetreatments.Arecentsystematic review6 of 35 studies suggests that CAM-related decision-making by patients with cancer occurs as a complex, nonlinear, dynamicprocess of information-seeking andevaluation. The results suggest a wide range of motivations behind the choice to use various types of CAMas patientsmove through the different phases of cancer treatment and recovery. In the early phase,whenpatients receive their initial cancerdiagnosis, the choice touseCAMseems tobeparticularly associatedwith the need to copewith the sense of loss of control. In later phases, the use of CAM seems to be directed toward perceived ends, such asmaintainingwell-being, controlling the spreadof cancer cells, boosting the immune system, and preventing or delaying recurrence. To provide the best evidence-based decision support regardingCAMuse—includingwhether touseCAMas a complementary or alternative treatment to AC—oncologists need to be actively involved in discussing CAM use with their patients.Onlybyacknowledging that communicationaboutCAM use is an important part of cancer carewill oncologists be able to help patients to make sufficiently informed choices about CAM use. However, as shown in a systematic review of the Related article page 1170 Complementary and Alternative Medicine and Chemotherapy Initiation Original Investigation Research

Complementary and Alternative Medicine Use in Individuals Presenting for Care at a Comprehensive Cancer Center.

Purpose: To define the use of complementary and alternative medicine (CAM) in individuals presenting for care at a comprehensive cancer center. Patients and Methods: A total of 17 639 individuals presenting to an NCI-designated Comprehensive Cancer Center (and consortium sites) completed a questionnaire regarding CAM use. Data were analyzed using the univariate χ2 test to assess CAM use associated with a number of variables, including cancer status, age, gender, marital status, ethnicity, race, employment, and education level. Results: Eighty-seven percent of individuals who completed the CAM survey acknowledged CAM therapy use within the previous 12 months. Of the 5 broad categories of CAM, the most commonly used were biologically based approaches (14 759/17 639 [83.67%]), mind-body interventions (4624/17 485 [26.45%]), manipulative and body-based therapies (3957/17 537 [22.56%]), alternative medical systems (429/15 952 [2.69%]), and energy therapies (270/15 872 [1.7%]). CAM use was more prevalent among women, non-Hispanics, Caucasians, patients 60 to 69 years of age, and those who are married, have a higher level of education, and are employed (P < .005). Conclusions: This is the largest report of CAM use in individuals presenting for care at a comprehensive cancer center. Our analysis revealed that a very high percentage of patients utilize CAM. Because many of these CAM interventions are not studied in oncology patients, additional research on safety, efficacy, and mechanisms of action are essential. Furthermore, it is important that oncologists understand CAM modalities and counsel their patients about their use.

(555) Complementary and alternative medicine use among children with pain in the United States: patterns, predictors, and perceived benefits

Growing evidence suggests that complementary and alternative medicine (CAM) may be useful in treating pediatric pain conditions. However nationally representative patterns of CAM use among children with pain are unknown. The 2012 National Health Interview Survey (NHIS) collects information on a broad range of health status variables in addition to information about use of 34 CAM modalities. Using data from NHIS we examined patterns, predictors, and perceived benefits of CAM use among children 4-17 years of age (M age = 10.5 years) with and without painful conditions. The NHIS sample (n=10,218) contained mostly white, non-Hispanic (53.7%) males (51.1%). Among participants, 2,796 (26.6%) reported pain (e.g. headache, abdominal, musculoskeletal pain) in the past year and of these 21.3% reported CAM use. In contrast only 8.1% of children without pain used CAM (χ2: p<.001). CAM use among children with pain was associated with female sex (adjusted odds ratio (OR)=1.54, p=0.002), higher income (OR=2.3, p<0.001), and having multiple comorbidities (OR=2.54, p<0.001). Furthermore, among children with pain, 7.2% used CAM specifically for pain management. Of these 100% reported that it was helpful in managing pain. Parents reported other health benefits of CAM for their children’s pain including improved energy (26%), improved sleep (55%), and reduced stress (49%). The 2 most commonly used CAM categories to specifically treat pain were manipulative (e.g., chiropractor, massage; 87%) and biology based (e.g., special diets, supplements; 33%) therapies. Many children who used CAM also used traditional health care services to treat their pain, including prescription medications (20%), over the counter medications (45%), physical therapy (15%), and mental health services (2.5%). These findings suggest that CAM is readily used by children with pain in the USA and many parents find it beneficial for their child’s symptoms. Future studies may identify which CAM modalities are most useful in treating pediatric pain.

Experiences and Attitudes of Complementary and Alternative Medicine among Postpartum Women

In this study was to obtain information of use of complementary and alternative medicine (CAM) among early postpartum women. Data collection was conducted in 3 Women's Hospital, D-city from 2015 August to 2015 September and a total of 143 subjects participated. Data were analyzed through frequency, test and ANOVA test. 90.2% of the subjects reported experienced CAM and 43.4% of the subjects reported adverse effects of the therapies. The most commonly used CAM category was natural products(80.0%). CAM-related information was being provided mostly through the advice of family and friends. Attitudes of CAM was 3.48±0.37 in 5 point. The results of this study suggests that systematic management and scientific research Received(November 20, 2015), Review request(November 21, 2015), Review Result(1st: December 03, 2015, 2nd: December 28, 2015) Accepted(January 05, 2016), Published(January 31, 2016) (Corresponding Author) 38428 Department of Nursing, Hosan University, 19, Daegyeong-ro 105-gil, Hayang-eup, Gyeongsan-si, Gyeongsangbuk-do, KOREA email: baesuhyun95@naver.com 51767 Department of Nursing, KyungnamUniversity, 7, Kyungnamdaehak-ro, Masanhappo-gu, Changwon-si, Gyeongsangnam-do, KOREA email: abigail@kyungnam.ac.kr 42601 College of Nursing, Keimyung University, 1095, Dalgubeol-daero, Dalseo-gu, Daegu, KOREA email: jsp544@kmu.ac.kr Experiences and Attitudes of Complementary and Alternative Medicine among Postpartum Women Copyright c 2016 HSST 132 is needed to provide accurate and safety information on the CAM that can be used for postpartum women. It also suggests that to grasp of nursing needs and to develop of the nursing interventions for use of CAM in postpartum women.

Complementary and Alternative Medicine Use in Women With Gynecologic Malignancy Presenting for Care at a Comprehensive Cancer Center.

We evaluated complementary and alternative medicine (CAM) practices among women presenting to a National Cancer Institute-designated Comprehensive Cancer Center with a gynecologic malignancy. Women with a gynecologic malignancy who had consented to enrollment in our institutional prospective clinical registry between January 2003 and January 2014 and who had completed a questionnaire assessing sociodemographic characteristics, medical histories, quality of life, and CAM use were considered for analysis. Among the 2508 women identified, responses to questions on CAM use were provided by 534 (21.3%). The majority of CAM question respondents were white (93.5%) and older than 50 years (76%). Overall, 464 women (87% of CAM question respondents) used at least 1 CAM therapy during the previous 12 months. The most commonly used CAM categories were biologically based approaches (83.5%), mind and body interventions (30.6%), and manipulative and body-based therapies (18.8%). The most commonly used individual CAM therapies were vitamins and minerals (78%), herbal supplements (27.9%), spiritual healing and prayer (15.1%), and deep breathing relaxation exercises (13.1%). Complementary and alternative medicine use was greatest in age groups 20 to 30 years and older than 65 years and was more prevalent among those who were widowed (P < 0.005), retired (P = 0.02), and with a higher level of education (P < 0.01). There was no association with cancer type, race, or ethnicity. Complementary and alternative medicine use is common among women being treated for gynecologic malignancy. Given the potential interactions of some CAM modalities with conventional treatment and the possible benefits in controlling symptoms and improving quality of life, providers should discuss CAM with their patients.

Complementary therapies for acne vulgaris.

Complementary therapies for acne vulgaris.

Factors affecting the use of complementary and alternative medicine among Japanese university students.

Patients suffering from intractable diseases and individuals seeking relief from mild symptoms resort to treatments outside the modern medical paradigm, such as complementary and alternative medicine (CAM). In order to improve doctor-patient communication about CAM, it is essential to evaluate CAM usage among social groups likely to choose it in the future. Therefore, we aimed to evaluate how university students - individuals highly subject to future CAM usage - perceive CAM and the factors affecting their choice of CAM use. We conducted a questionnaire survey with 1,096 Japanese university students not studying medical subjects. The term CAM was known to 11% of the subjects. Modalities they most associated with CAM were art therapy (353 subjects), hot spring therapy (349), and aromatherapy (345). They had experience taking vitamins, trace elements, other supplements (498), and nutritional drinks (483). Several subjects wanted to experience shiatsu massage (373) and hot spring therapy (303). Multiple regression analysis of the modalities that the subjects wanted to experience revealed a 42% multiple coefficient of determination for prioritizing modalities that the subject associated with CAM, showing a large contribution of this deciding factor. Although most subjects were not familiar with the term CAM, many of them had decided to ingest substances in the CAM category on the basis of self-judgment and without adequate knowledge. Because such behavior can be detrimental to health, medical professionals should be aware of CAM usage among their patients and seek effective communication with them in order to enable safe CAM practice.

The varied contribution of significant others to Complementary and Alternative Medicine (CAM) uptake by men with cancer: A qualitative analysis

PurposeTo explore how men's Significant Others (SOs), including family members and close friends, contribute to the uptake and maintenance of specific CAM therapies. MethodsThis study was the second, qualitative phase of a mixed-methods project investigating the use of CAM in an Australian male cancer population. Male participants were purposefully selected from a pool of 403 patients who answered a survey in the first quantitative phase (94% response rate and 86% consent rate for follow-up interview). Then semi-structured interviews among 26 men with a variety of cancers and 24 SOs were conducted. All 43 interviews were recorded, transcribed, and analysed thematically. ResultsMen used CAM/Natural products to cope with physical concerns, and this was actively supported by men's SOs who contributed to the uptake and maintenance of these CAMs. The shared CAM preparation and consumption functioned to strengthen the bond between men and their SOs, and also helped men's SOs to cope with uncertainty and regain control. In contrast, men practiced CAM/Mind-body medicine to receive emotional benefits, and only rarely shared this practice with their SOs, indicating a need for coping with emotions in a private way. ConclusionsMen's CAM use is a multifaceted process that can be better understood by considering CAM categories separately. CAM/Natural products help men to cope with physical concerns, while CAM/Mind-body medicine assist men to cope with their emotions in a private way. Oncology professionals can use this information to better promote and implement integrative cancer care services.

Biologically based therapies are commonly self-prescribed by Brazilian women for the treatment of advanced breast cancer or its symptoms

Breast cancer (BC) might be associated with loss of function in affected patients, with a direct impact on their quality of life (QOL). Many women with metastatic BC seek relief of symptoms, including the use of complementary and alternative medicine (CAM) to cure cancer. The present study aimed to identify the pattern of CAM used by patients with metastatic BC and to assess the correlation between CAM use and scores on anxiety, depression, and QOL scales. A total of 126 women with metastatic BC were interviewed using four instruments: (1) a questionnaire containing socioeconomic, clinical, and demographic data and CAM use; (2) European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ)-C30; (3) EORTC QLQ-BR23; and (4) the Hospital Anxiety and Depression Scale. Fifty percent of the participants reported the use of at least one CAM modality. Biologically based practices were the most frequently used to treat BC and/or its symptoms, the most commonly discussed with the oncologists, and one of the CAM categories in which more patients reported a desire to learn more about. The overall use of CAM was not correlated with the scores on the anxiety, depression, and QOL scales. However, analysis of the association of the QOL scores with specific CAM modalities revealed some potential associations (especially for food supplements, art therapy, psychotherapy, and prayer). Women with metastatic BC frequently make use of CAM to treat the cancer and/or its symptoms. Biologically based practices seem to be particularly important in Brazil. An association between specific CAM modalities and some QOL domains was suggested, but it needs further confirmation.

The use of complementary and alternative medicine for patients with traumatic brain injury in Taiwan

BackgroundThe use of complementary and alternative medicine (CAM) continues to increase in Taiwan. This study examined the use of CAM and beliefs about CAM as expressed by patients with traumatic brain injury (TBI) in Taiwan.MethodsTBI patients and their accompanying relatives were interviewed by using a structured questionnaire at an outpatient clinic in a medical center in northern Taiwan.ResultsA total of 101 patients with TBI participated in the study. Sixty-four (63%) patients had used at least one form of CAM after sustaining TBI. CAM users had used an average of 2.72 forms of CAM after sustaining TBI. The most frequently used CAM category was traditional Chinese medicine (37; 57.8%), followed by folk and religious therapies (30; 46.9%), and dietary supplements (30; 46.9%). The majority of the patients (45; 70.3%) did not report CAM use because they felt it was unnecessary to do so. Patients who used CAM had a significantly stronger positive belief in CAM than those who did not (t = −2.72; P = .008). After using CAM, most of the patients (54; 85%) perceived moderate satisfaction (2.89 ± 0.44), according to a 4-point Likert scale.ConclusionAlthough the use of CAM is common for TBI patients receiving conventional medical health care in Taiwan, most patients did not inform health care personnel about their CAM use. TBI patients perceive combined use of CAM and conventional medicine as beneficial for their overall health.

Predictors of Use of Complementary and Alternative Medicine by Non-Hodgkin Lymphoma Survivors and Relationship to Quality of Life

This study hypothesized that non-Hodgkin lymphoma (NHL) patients who used complementary and alternative medicine (CAM) would have higher health-related quality of life (HRQOL) and a greater perceived sense of control than nonusers. However, since CAM may predict HRQOL, and perceived control may be both associated with CAM use as well as being an independent predictor of HRQOL, the authors also sought to test whether perceived control mediated the relationship between CAM use and HRQOL. This was a cross-sectional study design. NHL survivors diagnosed between June 1, 1998 and August 31, 2001 were selected from the population-based SEER (Surveillance, Epidemiology, and End Results) cancer registry for Los Angeles County and were mailed a survey in 2003 that assessed CAM use and predictors of CAM use. The response rate was 54.8%; 319 provided complete data for analysis. Categories of CAM were defined according to the National Center for Complementary and Alternative Medicine guidelines. The authors measured survivors' cancer-related control using the Perceived Personal Control scale, a 4-question scale that was adapted from previously validated scales. HRQOL was measured using the mental component summary and physical component summary scores from the SF-36 v2.0. Bivariate and multivariable logistic and linear regression models were used to assess factors associated with CAM use and the association of CAM use with psychosocial health outcomes, respectively. Sixty-one percent of respondents reported using at least one CAM modality within the past 4 weeks, and 40% did so after excluding personal prayer and support groups. Younger age and higher education were significantly associated with greater CAM use as were higher perception of cancer-related control (P = .004) and more positive mental functioning (P = .016). Perception of control significantly mediated the association between CAM use and mental functioning (P < .001). CAM use may be related to more positive mental health-related quality of life by increasing patients' perception of perceived control over their health; however, cause and effect cannot be determined. Physicians should be aware that cancer survivors have a need to take an active role in improving their health.

P02.47. The relationship between CAM use and somatic symptom severity

Methods Data were collected prospectively through the PROCAIM Network, developed at UCLA. The Patient Health Questionnaire 15 (PHQ15) was used to measure 3 month change in symptom severity. All patients reported having chronic medical conditions characterized by chronic pain. Multivariate linear regression was used to evaluate: (1) The relationship between somatic symptom severity and the number of complementary and alternative medicine (CAM) modalities at baseline and during the three month period. (2) The relationship between somatic symptom severity and the NCCAM CAM categories.

The use of complementary and alternative medicine (CAM) in children: a telephone-based survey in Korea

BackgroundThe purpose of this study was to estimate the prevalence and patterns of CAM use in Korean children via a telephone based survey. We also investigated parent satisfaction, a proxy for their child, with CAM therapy and determined the factors affecting satisfaction with CAM use.MethodsThis study used a landline telephone-based survey to examine a random sample representative of Korean children, aged 0 to 18 years. We assigned and surveyed 2,000 subjects according to age group, gender, and geographical distributions by proportionate quota and systematic sampling of children throughout Korea in 2010. A household of 1,184 with a 18.6% response rate was projected to yield 2,077 completed data. We performed statistical analyses using sampling weight.ResultsThe prevalence of CAM use was 65.3% for the Korean children in our sample population. The most commonly used CAM category was natural products (89.3%). More than half of CAM user’s parents reported satisfaction with their therapies (52.7%), but only 29.1% among them had consulted a Western trained doctor regarding the CAM therapies used. Doctor visits were associated with lower satisfaction with CAM use but not with consultation rate with a doctor.ConclusionsOur study suggests that CAM is widely used among children in Korea. Medical doctors should actively discuss the use of CAM therapies with their patients and provide information on the safety and efficacy of diverse CAM modalities to guide the choices of CAM users.

Association of Health Literacy with Complementary and Alternative Medicine Use: A Cross-Sectional Study in Adult Primary Care Patients

BackgroundIn the United States, it is estimated that 40% of adults utilize complementary and alternative medicine (CAM) therapies. Recently, national surveys report that over 90 million adults have inadequate health literacy. To date, no study has assessed health literacy and its effect on CAM use. The primary objective of this study was to assess the relationship between health literacy and CAM use independent of educational attainment. Second objective was to evaluate the differential effect of health literacy on CAM use by race.Methods351 patients were recruited from an outpatient primary care clinic. Validated surveys assessed CAM use (I-CAM-Q), health literacy (REALM-R), and demographic information. We compared demographics by health literacy (adequate vs. inadequate) and overall and individual CAM categories by health literacy using chi square statistics. We found a race by health literacy interaction and ran sequential logistic regression models stratified by race to test the association between health literacy and overall CAM use (Model 1), Model 1 + education (Model 2), and Model 2 + other demographic characteristics (Model 3). We reported the adjusted effect of health literacy on CAM use for both whites and African Americans separately.Results75% of the participants had adequate literacy and 80% used CAM. CAM use differed by CAM category. Among whites, adequate health literacy was significantly associated with increased CAM use in both unadjusted (Model 1, OR 7.68; p = 0.001) and models adjusted for education (Model 2, OR 7.70; p = 0.002) and other sociodemographics (Model 3, OR 9.42; p = 0.01). Among African Americans, adequate health literacy was not associated with CAM use in any of the models.ConclusionsWe found a race by literacy interaction suggesting that the relationship between health literacy and CAM use differed significantly by race. Adequate health literacy among whites is associated with increased CAM use, but not associated with CAM use in African Americans.

Usage of alternative medical systems, acupuncture, homeopathy and anthroposophic medicine, by older German adults

The manifold studies on the usage of complementary and alternative medicine (CAM) indicate that its utilization differs with respect to socio-cultural background, gender, age and underlying disease. This study intended to analyze the usage of specific CAM practices among a population of older German adults with health insurance coverage. Data of 5 830 older individuals who participated in an anonymous cross sectional survey among German insurance beneficiaries were analyzed with respect to usage of CAM treatments applied by medical doctors or non-medical practitioners within the last 5 years. The most frequently used approaches were acupuncture/traditional Chinese medicine (21%), homeopathy (21%), movement therapies/physical exercises (19%), osteopathy/chiropractic (12%), herbs/phytotherapy (7%), diets/specific food recommendations (6%) and foot reflexology (5%). Anthroposophic medicine was used only to a minor degree. Acupuncture and homeopathy users were likely to choose more than one CAM treatment simultaneously, particularly the combination of homeopathy and acupuncture. Moreover, this study can confirm significant differences between women and men in the use of the main relevant CAM interventions. The relative proportion of acupuncture usage was similar to homeopathy, which is an alternative whole medical system originating from Western Europe. This means that an Eastern alternative system is established also in Germany. In several cases not only one CAM treatment was used but distinct combinations existed (particularly homeopathy and acupuncture); thus one should be cautious to draw predictive conclusions from studies with broad and unspecific CAM categories, for among them there are several therapies which should not be regarded as CAM.