Complementary And Alternative Medicine Modalities Research Articles

P046 Complementary and alternative medicine in patients with inflammatory bowel disease 20 years after diagnosis: Results from the IBSEN study

BACKGROUND: Use of complementary and alternative medicine (CAM) is common among IBD patients (1). The CAM modalities used include a wide specter of health care practices and therapies (2). In a previous study from this population, we found that almost one third of the patients used CAM 10 years after diagnosis (3). The aim of this follow-up study was to assess CAM use in IBD patients 20 years after diagnosis. METHODS: The Inflammatory Bowel South-Eastern Norway (IBSEN) study is a population based study with a prospective design. From January 1990 to December 1993, all newly diagnosed patients with IBD from a well defined area in South Eastern Norway were included in the cohort. The 20-year follow-up was conducted between 2011 and 2014 and included a structured interview, a review of patient records, a clinical examination, laboratory tests, and a questionnaire regarding CAM use. RESULTS: Of the 599 invited to attend the 20-year follow - up visit, 78.5% (UC = 314, CD = 156) participated in the follow- up study, whereof 93% (UC = 293 and CD = 146) completed the CAM questionnaire, 49% men. In total 122/439 (28%) reported use of CAM for their IBD, and 6% reported current CAM use. A significantly higher proportion women than men (60% vs 40%, P = 0.02) reported to use CAM. CAM users were younger (49 years) than the non-users (56 years), P < 0.001. A significantly higher proportion CD patients compared to UC patients (34% vs 25%, P = 0.04) reported CAM use. Treatment with CAM occurred more frequently in patients with more than one relapse the last year than in patients in remission (35% vs 21%, P = 0.003). The 3 most commonly used types of CAM were acupuncture 63/122 (52%), homeopathy 49/122 (40%) and herbal medicine 47/122 (39%). The 2 most common reasons for using CAM was as (1) a supplement to conventional treatment (41%) and (2) lack of effect from conventional medicine (32%). CONCLUSION(S): One third of the IBD patients reported CAM use 20 years after diagnosis. Prevalence of CAM use was comparable in the 10-year and 20-year follow- up. CAM use was more common among women, in younger patients, in UC patients, and in those with disease activity.

Formación académica en programas de profesiones sanitarias, conocimiento y uso de la Medicina Complementaria y Alternativa (MCA) por parte de los estudiantes universitarios

ObjectivesTo assess the association of academic education in health professions programs with the knowledge and use of Complementary and Alternative Medicine (CAM) by university students and to determine whether MCA can promote a healthy university environment. MethodsA cross-sectional study was carried out with 512 university students enrolled in health professions programs in the city of Fortaleza, Ceará, Brazil, from April to November 2017. The Assessment Tool for Health Promotion at the University was used to collect sociodemographic, academic and CAM data. Bivariate and multivariate analyses were performed considering the outcomes “knowledge of CAM” and “CAM in the promotion of a healthy university environment” using SPSS Statistic version 20.0. ResultsData from 512 participants were analyzed. Women (n=357; 69.7%), young students (n=393; 76.8%) and unemployed students (n=429; 83.8%) predominated. Knowledge of CAM was associated with health profession program (OR=0.934; p=0.047), paternal education (OR=0.641; p=0.024), employment (OR=0.542; p=0.028) and participation in extracurricular activities (OR=1.275; p=0.007). There was a proportional difference between knowledge and use of CAM ranging from 2:1 to 11:1 among the 21 modalities. University students believed that CAM could promote a healthy university environment (p=0.000), which was influenced by gender (OR=2.089; p=0.004) and knowledge of CAM (OR=16.601; p=0.000). ConclusionsUniversity students’ knowledge of CAM was influenced by the health profession program, paternal education, employment and participation in extracurricular activities. The percentage of use of CAM modalities was lower than the percentage of knowledge. University students’ belief that CAM could foster a healthy university environment is influenced by gender and knowledge of CAM.

Behaviors and Attitudes toward the Use of Complementary and Alternative Medicine among Korean Cancer Patients.

PurposeA cross-sectional survey was conducted to explore the current awareness and use of complementary and alternative medicine (CAM), as well as attitudes toward CAM, in patients with cancer and their family members in South Korea.Materials and MethodsBetween September 21 and October 31, 2017, a 25-item questionnaire regarding CAM experiences among cancer patients and their family members was conducted in 10 oncology clinics in South Korea after institutional review board approval at each institution.ResultsIn total, 283/310 patients were analyzed. The median age was 60 years, and 60% were male. Most of the patients were actively receiving anticancer treatment at the time of the survey. A total of 106 patients (37%) had experienced a median of two types (interquartile range, 1 to 3) of CAM. Belief in CAM (odds ratio [OR], 3.015; 95% confidence interval [CI], 1.611 to 5.640) and duration of disease (OR, 1.012; 95% CI, 1.004 to 1.020) were independent factors for using CAM in multivariable analysis. Belief in CAM was significantly associated with current use of CAM (OR, 3.633; 95% CI, 1.567 to 8.424). Lay referral was the most common reason for deciding to use CAM, and only 25% of patients (72/283) discussed CAM with their physicians.ConclusionPatient attitudes toward and confidence in CAM modalities were strongly associated with their CAM experiences, and only a small number of patients had an open discussion about CAM with their physicians. A patient education program for CAM is needed.

Complementary and Alternative Medicine Use by U.S. Adults with Self-Reported Doctor-Diagnosed Arthritis: Results from the 2012 National Health Interview Survey.

The use of complementary and alternative medicine (CAM) therapies have been reported for the management of arthritis. However, little is known about CAM use among adults with self-reported doctor-diagnosed arthritis. To determine (1) the prevalence and type of CAM use, (2) the difference in characteristics between CAM users and non-CAM users, and (3) the factors related to CAM use, among U.S. adults with self-reported doctor-diagnosed arthritis. Secondary analysis of the 2012 National Health Interview Survey (NHIS) data. The NHIS is a cross-sectional survey that gathers health-related data on the civilian, noninstitutionalized U.S. The NHIS 2012 uses a complex, multistage sampling design and oversamples minorities to achieve population representation; it included 34 525 adults, with 7179 adults having arthritis. Data were analyzed using Stata 15.1 survey syntax. The potential factors related to CAM use included sociodemographics and health-related characteristics. CAM modalities were categorized into six groups: natural products, manipulative therapies, mind-body therapies, special diets, movement therapies, and other practitioner-based CAM modalities. Of the adults with arthritis, 2428 (weighted estimate of 36.2% of U.S. adult population) had used CAM within the last year. Adults with arthritis reported greater use of CAM than those without, particularly the use of natural products, manipulative therapies and other practitioner-based CAM modalities. Factors associated with higher CAM use included being female, residing in regions other than the U.S. South, having a college degree or higher, reporting very good/excellent self-rated health status, and having current symptoms of joint stiffness/pain. As more than one-third of U.S. adults with arthritis seek CAM therapies, open and nonjudgmental conversations between conventional medicine providers, CAM providers, and patients should be encouraged to ensure patient health care needs are being met. III.

A cross-sectional assessment of knowledge, attitudes and self-perceived effectiveness of complementary and alternative medicine among pharmacy and non-pharmacy university students

BackgroundTraditional medicine has always been Pakistan’s cultural heritage, providing health care to a large part of its population. Thus, we aimed to assess and compare the knowledge, attitude, and perception about complementary and alternative medicine (CAM) between pharmacy and non-pharmacy students, the results of which may be helpful in devising national health-education policy.MethodsA cross-sectional study was conducted by enrolling 937 students, pharmacy (437) and non-pharmacy (500), of Punjab University, Lahore. A self-administered questionnaire was used for data collection. Data were analyzed using SPSS. (IBM v22).ResultsData suggested that majority of students knew about the use of traditional herbs and considered massage (P: 84.4%, NP: 82%, p = 0.099), homeopathy, herbs (P: 86.5%, NP: 81%, p = 0.064], yoga [P: 357 (81.7%), NP: 84%), p = 0.42] and spiritual healing (P: 85.6%, NP: 86.2%, p = 0.55) as effective and least harmful CAM modalities. The pharmacy students had better knowledge about CAM modalities compared to non-pharmacy students. Despite utilizing non-reliable sources of CAM information and their belief that CAM is practiced by quacks, the majority of students had positive attitudes and perceptions about CAM usage. Students also believed that CAM had a positive impact on health outcomes [P: 3.19 ± 1.04, NP: 3.02 ± 1.09, p = 0.008] and acceded to include CAM in the pharmacy curriculum. However, non-pharmacy students scored higher in their beliefs that CAM usage should be discouraged due to the non-scientific basis of CAM (P: 3.04 ± 0.97, NP: 3.17 ± 1.02, p = 0.028) and a possible threat to public health (P: 3.81 ± 1.74, NP: 4.06 ± 1.56, p = 0.02). On the other hand, pharmacy students believed that patients might get benefits from CAM modalities (P: 4.31 ± 1.48, NP: 4.12 ± 1.45, p = 0.02). Majority of students perceived that spiritual healing is the most useful and safer CAM modality, while acupuncture (P: 25.4%, NP: 21.8%, p = 0.0005), hypnosis (P: 26.8%, NP: 19.6%, p = 0.001) and chiropractic (P: 18.8%, NP: 11.6%, p = 0.0005) were among the harmful ones.ConclusionIn conclusion, despite poor knowledge about CAM, students demonstrated positive attitudes and beliefs regarding CAM. They exhibited better awareness about yoga, spiritual healing/prayer, herbs, and massage. Students also showed willingness to advance their knowledge about CAM and favored its inclusion in the curriculum.

Prevalence and predictors of complementary and alternative medicine modalities in patients with chronic hepatitis B.

The use of complementary and alternative medicine (CAM) in patients with chronic hepatitis B (CHB) can interact with antiviral treatment or influence health-seeking behaviour. We aimed to study the use of individual CAM modalities in CHB and explore determinants of use, particularly migration-related, socio-economic and clinical factors. A total of 436 CHB outpatients who attended the Toronto Centre for Liver Disease in 2015-2016 were included in this cross-sectional study. Using the comprehensive I-CAM questionnaire and health records, data were collected on socio-demographic and clinical variables and on usage of 16 CAM modalities in the last year. Sixty percent of patients were male, 74% were Asian and 46% were using antiviral treatment. Three-hundred and nine (71%) patients used CAM. Vitamin/mineral preparations (45% of patients) were most commonly used. Overall CAM use and the specific use of potentially injurious CAM, such as green tea extract (9.2%) and St. John's wort (0.2%), were not associated with liver disease severity. Female sex, family history of CHB, lower serum HBV DNA, and higher socio-economic status were independently associated with bio-holistic CAM use, the clinically most-relevant CAM group (P<0.05); ethnicity, antiviral therapy use and liver disease severity were not. CAM use among CHB patients was extensive, especially use of vitamin and mineral preparations, but without direct influence on liver disease severity. Bio-holistic CAM use appeared to be associated with socio-economic status rather than with ethnicity or liver disease severity. Despite the rare use of hepatotoxins, physicians should actively inquire about it.

Usage and attitudes related to complementary and alternative medicine among Turkish academicians on the basis of the five-factor model of personality: A multi-centered study

ObjectivesAs the popularity of complementary and alternative medicines (CAM) is increasing, it is important to understand the characteristics of people that make them to be attracted toward CAM and influence their attitudes. The purpose of the present study was to examine the associations between the socio-demographic characteristics of people as assessed by the a five-factor model and the attitudes toward CAM modalities among Turkish academicians. DesignAn online survey was completed by 227 academicians who were working in three leading universities of Turkey. Main outcome measuresThe academicians were queried anonymously on socio-demographics and which CAM modalities they utilized, by filling out the Ten-Item Personality Inventory (TIPI) and the Holistic Complementary and Alternative Health Questionnaire (HCAMQ). ResultsIn regard to the intention of using a CAM modality in the academicians, 75.3% of the academicians specified an intention to use at least one form of CAM in their lives. Among all the academicians surveyed, 38.8% reported using at least one form of CAM in the previous year. The most widely used forms of CAM observed were herbal therapies and mind-body therapies (18.5%), touch-based therapies (15.4%), and multi-vitamin (4.8%). The ratio of CAM usage in the previous year was observed to be lower in the academicians working in the health-related professions. The present study also identified that the academicians with openness personality-type exhibited greater positive attitudes toward CAM (p < 0.05). ConclusionsThe findings of the present study indicated that the academicians who are open to experience, as assessed by the five-factor model of personality, exhibited greater positive attitudes toward CAM. More than 60% of academicians agreed that CAM should be integrated into the curriculum, the remaining participants were unsure and disagreed. Therefore, the required feasibility studies to integrate CAM courses into the curriculum of Turkish medical and nursing schools are recommended as a priority.

Integrative medicine in Dutch curative and long-term healthcare centres: Mapping the field

IntroductionLittle is known about integration of Complementary and Alternative Medicine (CAM) in the Dutch healthcare system. The aim of the present study was to investigate how Integrative Medicine (IM) is practiced and how CAM is integrated with conventional medicine in curative and long-term healthcare centres in the Netherlands. MethodsA mixed methodology was applied, including a systematic internet search, an online survey and focus groups among healthcare professionals. ResultsMost hospitals (92%) offered some form of CAM to treat anxiety (72%), restlessness (68%), pain (65%), sleeping problems (50%), stress (48%) and fatigue (36%). Mostly offered modalities were relaxation exercises (88%), art therapy (44%) and mindfulness (42%). Similar percentages of CAM use were found in other healthcare centres. Most CAM modalities were implemented without organizational vision, guidelines or protocols. Only 5% of implemented CAM was labelled as IM. Focus groups with health care professionals revealed the need to increase knowledge and to develop a vision for integration of CAM with conventional medicine, as well as to support effectiveness research in this area. ConclusionsThis study is the first in the Netherlands to quantitatively map the extent of CAM integration in conventional health care. The number of CAM interventions offered at conventional health care settings was surprisingly high. However, integration was fragmented. Guidelines, education and research programs are needed to further integration of CAM, preferably organised in a Dutch Consortium for IM.

Use and acceptance of complementary and alternative medicine among medical students: a cross sectional study from Palestine

BackgroundTeaching Complementary and alternative medicine (CAM) in medical schools is becoming prevalent worldwide. Few studies have been conducted to evaluate medical students’ knowledge and attitude toward CAM. Therefore, this study was designed to assess CAM knowledge, attitudes, and beliefs among Palestinian medical students.MethodsThis study was developed in a cross-sectional design. It targeted medical students at An-Najah National University, between January and April of 2018. We gathered the data from students using a questionnaire printed as a hard copy. Medical students of both sexes in their 4th, 5th, or 6th year of studies were included in the survey. The questionnaire consisted of 3 sections: demographic characteristics and detailed practices of the participants, their attitude and held beliefs towards CAM, and their knowledge on CAM. Mann-Whitney U Test and Kruskal-Wallis Test were used to test if there were differences between knowledge about CAM and the characteristics of the participants.ResultsOf the 300 medical students who were offered the questionnaire, 251 students (43.8% male and 56.2% female) were included in the final analysis. Out of a maximum of 8 points, the mean knowledge score of the participants was 2.0 ± 1.6. The Kruskal-Wallis test showed a statistically significant difference in overall knowledge score among students of different year groups, with students at lower levels obtaining higher scores (P < 0.001). Additionally, the highest knowledge scores were found in students with low income, and students who came from the Palestinian refugee camps (P < 0.001). Students frequently recommended CAM modalities, with herbal medicine being the most recognized and used CAM modality and Ayurvedic medicine being the least recognized and recommended one. Social media was the most popular source of information about CAM, cited by 72.9% of the participants. Participants generally had a good attitude towards CAM but held varying beliefs about it.ConclusionsIn the current study, a knowledge gap regarding CAM was found among medical students in our sample, despite their good attitude towards the subject. Also, there was a general acceptance to include materials on CAM within the curriculum of medical students.

Academic education in health profession programs, knowledge and use of Complementary and Alternative Medicine (CAM) by university students

ObjectivesTo assess the association of academic education in health professions programs with the knowledge and use of Complementary and Alternative Medicine (CAM) by university students and to determine whether CAM can promote a healthy university environment. MethodsA cross-sectional study was carried out with 512 university students enrolled in health professions programs in the city of Fortaleza, Ceará, Brazil, from April to November 2017. The Assessment Tool for Health Promotion at the University was used to collect sociodemographic, academic and CAM data. Bivariate and multivariate analyses were performed considering the outcomes “knowledge of CAM” and “CAM in the promotion of a healthy university environment” using SPSS Statistic version 20.0. ResultsData from 512 participants were analyzed. Women (n = 357; 69.7%), young students (n = 393; 76.8%) and unemployed students (n = 429; 83.8%) predominated. Knowledge of CAM was associated with health profession program (OR = 0.934; p = 0.047), paternal education (OR = 0.641; p = 0.024), employment (OR = 0.542; p = 0.028) and participation in extracurricular activities (OR = 1.275; p = 0.007). There was a proportional difference between knowledge and use of CAM ranging from 2:1 to 11:1 among the 21 modalities. University students believed that CAM could promote a healthy university environment (p = 0.000), which was influenced by gender (OR = 2.089; p = 0.004) and knowledge of CAM (OR = 16.601; p = 0.000). ConclusionsUniversity students’ knowledge of CAM was influenced by the health profession program, paternal education, employment and participation in extracurricular activities. The percentage of use of CAM modalities was lower than the percentage of knowledge. University students’ belief that CAM could foster a healthy university environment is influenced by gender and knowledge of CAM.

Cancer patients\u2019 use of complementary and alternative medicine in Sweden: a cross-sectional study

BackgroundAccess to and advice on Complementary and Alternative Medicine (CAM) are uncommon within Swedish conventional cancer care and little is known about cancer patients’ own use of CAM. The aim of this cross-sectional study was to explore Swedish cancer patients´ patterns of CAM use, their experiences and preferences.MethodsQuestionnaires were distributed consecutively to 1297 cancer patients at a university hospital’s out-patient oncology units. The response rate was 58% (n = 755). Descriptive statistics were used to analyze the survey data. A logistic regression model was used to investigate the association between CAM use and gender, age and level of education. Open-ended responses were analyzed, using qualitative content analysis.ResultsLifetime CAM use was reported by 34% (n = 256), and 26% (n = 198) used CAM after cancer diagnosis. Being female, younger and having higher education predicted CAM use. Most commonly used methods were natural products including vitamins and minerals and relaxation. Main reasons for CAM use were improvement of physical, general and emotional wellbeing and increasing the body’s ability to fight cancer. Satisfaction with CAM usage was generally high. Reported adverse effects were few and mild; 54% of users spent < 50 Euro a month on CAM. One third had discussed their CAM use with cancer care providers. More than half of all participants thought that cancer care providers should be able to discuss (58%) and to consider (54%) use of CAM modalities in cancer care.ConclusionsDespite limited access and advice within conventional cancer care, one fourth of Swedish cancer patients use CAM. The insufficient patient-provider dialogue diverges with most patients’ wish for professional guidance in their decisions and integration of CAM modalities in conventional cancer care. Concurrent and multimodal CAM use implies challenges and possibilities for cancer care that need to be considered.

The Use of Complementary and Alternative Medicine among Korean Young Adult Members of Fitness Centers.

In general, the pattern and perception of complementary and alternative medicine (CAM) use in young people are little known. Particularly, given South Korea's dual health care system that includes both Korean traditional medicine and Western medicine, young adults in South Korea may be unique for the study of CAM use. Accordingly, this study investigated the modality, purpose, and perceptions of CAM use among young adults in South Korea and determined the predictors of CAM use. In addition, reasons for CAM use were compared to those for exercise. A survey was conducted among 649 young members of fitness centers (aged 20-39 years). The structured written questionnaire included the questions related to use of 30 CAM modalities, satisfaction with CAM use, factors associated with CAM use, reasons for exercise and CAM use, and perceptions of CAM. The most common therapies used in lifetime were acupuncture, massage, moxibustion/cupping, yoga, and diet-based therapies. The most satisfied therapy was massage followed by aroma therapy. The main reasons for using CAM were to relieve musculoskeletal pains while those for doing exercise were to lose weight, to promote health, and to have a positive body image. Multiple logistic regression analysis revealed that higher education level, having a religion, and having a health problem were significant independent predictors of CAM use after controlling for other factors. The majority of respondents reported “relief of pain and symptoms” as the perceived effect of CAM and “lack of advertising” as the weakness of CAM. The majority of respondents got CAM information from mass media and Internet. In conclusion, CAM use is significantly associated with education level, religious status, and health status in Korean young adult members of fitness centers. The main purposes of utilizing CAM and performing exercise are different.

Knowledge, attitudes, and practice of complementary and alternative medicine among diabetic patients

Background: Complementary and alternative medicine (CAM) is defined as a group of various medical and healthcare systems, practices, and products that are not generally considered part of conventional western medicine. Objective: This study was carried out to estimate the prevalence of CAM use among diabetic patients and to assess knowledge, attitudes, and practice of CAM among diabetic patients. Materials and Methods: This is a hospital-based cross-sectional study done at diabetic center of Merjan teaching hospital on 200 patients. Results: This study estimated that the prevalence of CAM use among diabetic patients at Babylon province was 48.5%; the most common type of CAM used by diabetic patients was Herbal products (24.7%), while nutritional supplements and spiritual healing together used by (18.6%)of (CAM) users, herbal products and nutritional supplements together at rate of (14.4%) and (40.2%) use the 3 types of CAM modalities together. The most common type of Herbal products used by diabetic patients were Garlic which used at (16.9%), while Lemon used by (19.1%) of Diabetic patients, Cinnamon (Darcin) (10.2%), Fenugreek (Helba) (8.8%), (7.3%) bitter gum, and (18.3%) were a mixture of herbs, (7.3%) black seed. (62%)of Subjects had good knowledge about (CAM),(28%) had fair knowledge and (10%) poor knowledge. (66%) of (CAM )users had negative attitudes toward (CAM) and (34%) had positive attitude. Conclusion: Our study estimated the prevalence of CAM use among diabetic patients, revealed good knowledge of the diabetic patients and negative attitudes of CAM users, and showed five significant associations with score of knowledge and attitudes (age, educational level, residence, family history of DM, and follow-up visits), which was consistent with some studies in other eastern and western countries.

Expanding vocabularies for complementary and alternative medicine therapies

ObjectiveThere is a significant consumer demand for complementary and alternative medicine (CAM) therapies as possible alternatives to drugs in the treatment and prevention of chronic diseases. Expanding controlled vocabularies to include CAM treatment relations could help meet those needs by facilitating information retrieval from the published literature. The purpose of this study is to design and evaluate two methods to semi-automatically extract CAM treatment-related semantic predications (subject-predicate-object triplets) from the biomedical literature using the Semantic Medline database (SemMedDB). MethodsPredications were retrieved from SemMedDB, a database of semantic predications extracted from article abstracts available in Medline. Predications were retrieved for 20 biologically-based and 3 mind-body CAM therapies. The first method (allMedline) retrieved predications from any Medline citation, while the second method (soundStudies) only retrieved predications from scientifically sound clinical studies. Filtering criteria were applied to identify the predications focusing on the treatment and prevention of medical disorders using various CAM modalities. The disorders were extracted for each CAM therapy and ranked by occurrence. A reference vocabulary, composed of 20 biologically-based and 3 mind-body CAM therapies, was developed to evaluate the performance of each method according to precision and recall of the top 100 ranked concepts as well as average precision and recall. ResultsThe difference between allMedline and soundStudies in terms of median precision for the top 100 concepts ranked by occurrence was significant (21.0% versus 27.0%, p < .001). The soundStudies method had significantly higher precision (7.0% vs 11.5%, p < .001) and the allMedline had significantly higher recall (37.1% vs 25.6%, p < .001). ConclusionThe soundStudies method may be useful for extracting treatment-related predications from the biomedical literature for the highest ranked concepts. Additional work is needed to improve the algorithm as well as identify and report shortcomings for future enhancements of the tools used to populate SemMedDB.

Use of complementary and alternative medicine by oncology patients: challenges and opportunities

The article by Jones and colleagues (1) recently published in Integrative Cancer Therapies reported on complementary and alternative medicine (CAM) use by minority and medically underserved oncology patients at one hospital setting in Houston, Texas, USA. They find that cancer patients had very high awareness and interest in various CAM modalities as well as high prevalence of use of CAM. The authors conclude that while CAM use is common among the oncology patients they surveyed it, is not guided by providers and they highlight the importance of patient-provider discussions about CAM.

Complementary and alternative medicine use among persons with multiple chronic conditions: results from the 2012 National Health Interview Survey

BackgroundAlthough a quarter of Americans are estimated to have multiple chronic conditions, information on the impact of chronic disease dyads and triads on use of complementary and alternative medicine (CAM) is scarce. The purpose of this study is to: 1) estimate the prevalence and odds of CAM use among participants with hypercholesterolemia, hypertension, diabetes, and obesity; and 2) examine the effects of chronic condition dyads and triads on the use of CAM modalities, specifically manipulative and body-based methods, biological treatments, mind-body interventions, energy therapies, and alternative medical systems.MethodsData were obtained from the 2012 National Health Interview Survey and the Adult Alternative Medicine supplement. Statistical analyses were restricted to persons with self-reported hypercholesterolemia, hypertension, diabetes, or obesity (n = 15,463).ResultsApproximately 37.2% of the participants had just one of the four chronic conditions, while 62.4% self-reported multiple comorbidities. CAM use among participants was as follows (p < 0.001): hypercholesterolemia (31.5%), hypertension (28.3%), diabetes (25.0%), and obesity (10.8%). All combinations of disease dyads and triads were consistently and significantly associated with the use of mind-body interventions (2–4%, p < 0.001). Two sets of three dyads were associated with use of manipulative methods (23–27%, p < 0.05) and energy therapies (0.2–0.3%, p < 0.05). Use of biological treatments (0.04%, p < 0.05) and alternative systems (3%, p < 0.05) were each significant for one dyad. One triad was significant for use of manipulative methods (27%, p < 0.001).ConclusionsThese findings point to future directions for research and have practical implications for family practitioners treating multimorbid patients.

2.3 Complementary and Alternative Medicine Use in Child and Adolescent Psychiatry

Complementary and alternative medicine (CAM) has increasingly become a topic of interest among the general public. The effectiveness of CAM in treating mental illnesses has also been a topic of research interest, although research involving children and adolescents is still limited. This study investigates the use in treatment and beliefs about CAM modalities among child and adolescent psychiatrists. In addition, a comparison of the scholarly evidence base versus use of specific CAM modalities will be discussed.

Complementary and alternative medicine for treatment of atopic eczema in children under 14\xa0years old: a systematic review and meta-analysis of randomized controlled trials

BackgroundDue to limitations of conventional medicine for atopic eczema (AE), complementary and alternative medicine (CAM) is widely used as an alternative, maintaining, or simultaneous treatment for AE. We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old.MethodsWe searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018. We included children (< 14 years) diagnosed with AE, who received CAM therapy alone or combined with conventional medicine. We extracted data, and used the Cochrane “Risk of bias” tool to assess methodological quality. Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3.ResultsTwenty-four randomized controlled trials involving 2233 children with AE were included. Methodological quality was of unclear or high risk of bias in general. The trials tested 5 different types of CAM therapies, including probiotics, diet, biofilm, borage oil, and swimming. Compared to placebo, probiotics showed improved effect for the SCORAD index (MD 9.01, 95% CI 7.12–10.90; n = 5). For symptoms and signs such as itching, skin lesions, CAM combined with usual care was more effective for symptom relief ≥95% (RR 1.47, 95% CI 1.30–1.68; n = 8), and for ≥50% symptoms improvement (RR 1.34, 1.25–1.45; n = 9) compared to usual care. There was no statistic significant difference between CAM and usual care on ≥95% improvement or ≥ 50% improvement of symptoms. However, swimming, diet and biofilm showed improvement of clinical symptoms compared with usual care. At follow-up of 8 weeks to 3 years, CAM alone or combined with usual care showed lower relapse rate (RR 0.38, 0.28–0.51, n = 2; RR 0.31, 0.24–0.40, n = 7; respectively) compared to usual care. Twelve out of 24 trials reported no occurrence of severe adverse events.ConclusionsLow evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate. Safety remains unclear due to insufficient reporting. Further well-designed randomized trials are needed to confirm the potential beneficial effect and to establish safety use.

Complementary and Alternative Methods for Treatment of Acne Vulgaris: a Systematic Review

To review the current literature regarding complementary and alternative treatment options for acne vulgaris. Acne vulgaris is an increasingly prevalent disease worldwide. While conventional methods of treatment are still primarily used to treat acne, complementary and alternative methods of treatment are becoming utilized in conjunction or in place of prescription medications. Studies have shown comparable benefit of Complementary and Alternative Medicine (CAM) therapies to conventional treatment. Oral green tea extract was a moderately effective treatment of inflammatory acne without significant side effects. Nicotinamide oral and topical preparations demonstrated efficacy in the treatment of moderate inflammatory acne without significant side effects. Oral zinc gluconate was not as effective as oral minocycline in the treatment of inflammatory acne. CAM therapy has relatively few reported side effects for acne vulgaris, and is mildly effective in treatment of inflammatory and comedonal acne. More studies are needed for further comparison of CAM modalities with each other as well as with conventional treatment.

English

Complementary and alternative medicine has been an important part of Pakistani culture for a long time. Whilst it is widely practiced amongst the general population, this study aims to determine attitude and practices of medical students towards complementary and alternative medicine (CAM), and their willingness to learn about them and give advice to their patients about it in future. Cross sectional study was conducted using a self administered questionnaire on the medical students of a public and private sector medical college in Karachi. Students from all years of bachelor of medicine and bachelor of dental surgery (BDS) program were included and were approached using convenience sampling. The data was collected and analyzed using statistical package for social sciences (SPPS) version 21. The study included 246 students and showed they had a positive attitude regarding CAM. Only 18.3% respondents appeared not to be using any of the CAM modalities mentioned in the questionnaire. Participants were more inclined to opt for CAM for common ailments like headache flu rather than medical emergencies in which allopathic medicine was the first choice of treatment. Results showed willingness of 56.4% respondents to advice their patients about CAM in future .Regarding barriers pertaining to usage of CAM, the most important was the belief in the ineffectiveness of CAM (39.5%). Respondents in general believed in the effectiveness of CAM and showed willingness to be trained in various CAM modalities. Considering the widespread popularity of CAM methods amongst medical students, incorporating this in their curriculum could prove really helpful and may aid in better health care for patients in the future. Key words: Complementary and alternative medicine, medical students.