Complementary And Alternative Medicine Modalities Research Articles

Natural or Plant Products for the Treatment of Neurological Disorders: Current Knowledge.

In recent decades, complementary and alternative medicine (CAM) has become very popular in the treatment of several chronic diseases. Natural products as one of the CAM modalities offer potential opportunities to discover lead compounds for novel drug development. The use of CAM or natural products in the prevention of neurodegenerative diseases is comparatively a newer area. A structured online literature search for peer-reviewed research articles was conducted on the PubMed, Europe PMC, Medline and Google Scholar portals, using phrases: natural products for neurologic disorders, phytomedicine for neurodegenerative diseases, natural therapeutics for neurological symptopms etc. Results: The retrieved data showed the natural therapeutics with anti-oxidative and anti-inflammatory salutations evidently plays a crucial role in protecting neurons. Of these, the most promising are caffeine, trigonelline, shogaol, curcumin, resveratrol, baicalein, wogonin, ginsenosides, tanshinones, withanolides, picrosides, parthenolide, cannabinoids, Devil's claw and white willow bark, including Chinese formulations Renshen Shouwu and Shengmai San. Though several herbs and their active ingredients have been studied in laboratory and clinical settings, only a few have been investigated for their molecular mechanisms of action. Notably, despite the promising and safe therapeutic benefits of CAM/herbal medicines, there exists a possible risk when combining them with prescription drugs. As a result, many drugs have shown changes in blood pressure, hepatotoxicity, seizures etc. when combined with certain herbs. Certainly, extensive work is needed to make sure that patients should take a regimen of protective and restorative therapy under an experienced healthcare professional. This article updates on the current knowledge of promising natural products used in neurological disorders.

‘You Feel It in Your Body’: Narratives of Embodied Well-Being and Control among Women Who Use Complementary and Alternative Medicine during Pregnancy

In Western societies, women’s use of complementary and alternative medicine (CAM) during pregnancy and labor is increasingly ubiquitous, yet there have been few in-depth explorations of the lived experience of women who use CAM and little critical analysis of CAM’s contribution to women’s overall experience of pregnancy and childbirth. This paper explores women’s narrative accounts of CAM use during pregnancy and childbirth to help uncover the meanings they attribute to CAM use. A qualitative narrative methodology was selected for this study, as it gives prominence to meanings that individuals assign to life events. A purposive sample of 14 women who were familiar with using a range of CAM modalities during pregnancy and childbirth took part in the study. This paper highlights different ways the women engaged with CAM, and how their embodied experiences became the mechanism by which CAM use, value, and safety were judged. CAM use in relation to embodiment became one way the women could reorder their world during pregnancy and childbirth. Moreover, CAM use among pregnant women may lead to the perception of more control and agency, but it also reinforces essentialist and naturalist conceptions of women’s identities and bodies.

Complementary and Alternative Medicine Usage by Multiple Sclerosis Patients: Results from a Prospective Clinical Study.

To investigate the factors associated with complementary and alternative medicine (CAM) usage by multiple sclerosis (MS) patients. Design, Setting/Location: Single-center, prospective clinical study at an academic MS center in the northeastern United States. This study included CAM data from 524 MS patients and 304 healthy controls (HC) enrolled in a prospective study of clinical, neuroimaging, and environmental risk factors in MS at an academic MS Center. Clinical, neuroimaging, and disease-modifying treatment data were obtained. In addition, data on usage of CAM modalities, including acupuncture, aromatherapy, Ayurveda, Chinese herbal medicine, chiropractor, electromagnetic therapy, homeopathy, hypnosis, massage, naturopathy, Qi gong, Reiki, therapeutic touch, and bee stings were collected in an in-person interview. The percentages of HC reporting usage of any CAM (32%) was similar to that in MS patients after diagnosis (30.5%). The usage of any CAM was higher in MS patients after MS diagnosis compared to before MS diagnosis (p < 0.001). The three most frequently used CAM for MS patients after MS diagnosis and HC were chiropractor, massage, and acupuncture. The most frequent reasons for CAM use were MS symptom relief, back problems, and pain. In multivariate analysis, female gender, higher education level, MS disease course, and not currently on disease-modifying therapies (DMT) treatment status were associated with CAM usage. Gender, education level, DMT treatment status, and MS disease course are associated with CAM usage in MS patients. Ever-CAM usage patterns in MS patients are similar to those in HC.

Perspectives of Oncology Nurses on Complementary and Alternative Medicine in Turkey: A Cross-Sectional Survey.

In Turkey, between 22.1% and 84.1% of patients with cancer use complementary and alternative medicine (CAM). However, few CAM-related studies have focused on the perspective of oncology nurses. This study aimed to determine the knowledge, attitudes, and practices of Turkish oncology nurses regarding CAM. A descriptive cross-sectional survey of 127 participants was conducted in Ankara, Turkey. A semistructured questionnaire including characteristics, knowledge, attitudes, and practices of oncology nurses toward CAM was administered to participants. We found that more than half of nurses (54.0%) surveyed had no information on CAM modalities. Most oncology nurses (81.1%) used audiovisual media sources to obtain CAM information. Many nurses (81.3%) reported not using any CAM in cancer care, and only 26.8% recommended CAM to patients. Most nurses used CAM to accelerate wound healing (19.7%) and to manage symptoms, including constipation and diarrhea (8.8%) and anxiety (7.9%). Music (52.8%), massage (49.6%), and exercise (48.8%) were stated to be beneficial. Important barriers to use CAM for patients with cancer involved a lack of knowledge (60.6%); needing physician approval to apply any CAM methods to patients (52.1%); legal and institutional issues (47.2%); and limited educational, training, or certificate programs (44.1%). There is a need for increased knowledge about CAM by oncology nurses, considering their vital role in symptom management of patients with cancer. This can be achieved through solving legal and institutional problems, structured and comprehensive education/training programs, and the integration of CAM therapy into cancer care guidelines.

Caregivers' knowledge and acceptance of complementary and alternative medicine in a tertiary care pediatric hospital.

BackgroundThe use of complementary and alternative medicine (CAM) therapies has increased in children, especially in those with chronic health conditions. However, this increase may not translate into acceptance of CAM in the perioperative setting. We surveyed caregivers of patients undergoing surgery to determine their knowledge and acceptance of hypnotherapy, acupuncture, and music therapy as alternatives to standard medication in the perioperative period.Materials and methodsAn anonymous, 12-question survey was administered to caregivers of children undergoing procedures under general anesthesia. Caregivers reported their knowledge about hypnotherapy, music therapy, and acupuncture and interest in one of these methods during the perioperative period. CAM acceptance was defined as interest in one or more CAM methods.ResultsData from 164 caregivers were analyzed. The majority of caregivers were 20–40 years of age (68%) and mothers of the patient (82%). Caregivers were most familiar with acupuncture (70%), followed by music therapy (60%) and hypnotherapy (38%). Overall CAM acceptance was 51%. The acceptance of specific CAM modalities was highest for music therapy (50%), followed by hypnotherapy (17%) and acupuncture (13%). In multivariable logistic regression, familiarity with music therapy was associated with greater odds of CAM acceptance (odds ratio=3.36; 95% CI: 1.46, 7.74; P=0.004).ConclusionOverall CAM acceptance among caregivers of children undergoing surgery was 51%, with music therapy being the most accepted CAM method. Familiarity with music therapy was the only factor that was independently associated with accepting CAM in the perioperative period. The low acceptance for acupuncture and hypnosis in the perioperative situation may be related to insufficient parental knowledge and information.

Which risk understandings can be derived from the current disharmonized regulation of complementary and alternative medicine in Europe?

BackgroundMany European citizens are seeking complementary and alternative medicine (CAM). These treatments are regulated very differently in the EU/EFTA countries. This may demonstrate differences in how risk associated with the use of CAM is perceived. Since most CAM treatments are practiced fairly similarly across Europe, differing risk understandings may influence patient safety for European CAM users. The overall aim of this article is thus to contribute to an overview and awareness of possible differing risk understandings in the field of CAM at a policymaking/structural level in Europe.MethodsThe study is a re-analysis of data collected in the CAMbrella EU FP7 document and interview study on the regulation of CAM in 39 European countries.The 12 CAM modalities included in the CAMbrella study were ranked with regard to assumed risk potential depending on the number of countries limiting its practice to regulated professions. The 39 countries were ranked according to how many of the included CAM modalities they limit to be practiced by regulated professions.ResultsTwelve of 39 countries generally understand the included CAM treatments to represent “high risk”, 20 countries “low risk”, while the remaining 7 countries understand CAM treatments as carrying “very little or no risk”. The CAM modalities seen as carrying a risk high enough to warrant professional regulation in the highest number of countries are chiropractic, acupuncture, massage, homeopathy and osteopathy.The countries understanding most of the CAM modalities in the study as potentially high-risk treatments are with two exceptions (Portugal and Belgium) all concentrated in the southeastern region of Europe.ConclusionThe variation in regulation of CAM may represent a substantial lack of common risk understandings between health policymakers in Europe. We think the discrepancies in regulation are to a considerable degree also based on factors unrelated to patient risk. We argue that it is important for patient safety that policy makers across Europe address this confusing situation. This could be done by applying the WHO patient safety definitions and EU’s policy to facilitate access to “safe and high-quality healthcare”, and regulate CAM accordingly.

Complementary, Alternative and Integrative Medicine for Childhood Atopic Dermatitis.

Atopic Dermatitis (AD) is a chronic relapsing dermatosis associated with itch, sleep disturbance and poor quality of life. Treatment of AD includes the use of emollients, and topical and systemic immunomodulating agents. Many patients also use complementary and alternative medicine (CAM). This article reviews the pathophysiology of AD, clinical trials and recent patents involving various modalities of CAM in the treatment of AD. A Medline/Pubmed search was conducted using Clinical Queries with the key terms "Chinese Medicine OR Complementary and Alternative medicine" AND "Eczema OR Atopic dermatitis". The search strategy included meta-analyses, Randomized Controlled Trials (RCTs), clinical trials, reviews and pertinent references. Patents were searched using the key term "atopic dermatitis" from www.google.com/patents, www.uspto.gov, and www.freepatentsonline.com. Only a few RCTs evaluated the efficacy of Chinese medicinal herbs in treating AD. There was some evidence for other modalities of CAM. Integrative Medicine (IM) usually refers to the various forms of CAM that combine conventional western medicine and Chinese medicine. Supporting evidence for the efficacy of IM in the treatment of AD is presently lacking. Integration is difficult. Western medicine practitioners are often ignorant about CAM and IM. Parents are concerned about the potential side effects of Western medicine and will tend to be non-compliant with the conventional Western component of IM. Recent patents on CAM and IM are reviewed. Most CAM patents are herbal compositions, evidence on their efficacy is generally lacking. AD is a complex disease. The psychodynamics of the child and his/her family is the reason for the often suboptimal outcomes. Both Western and CAM practitioners should collaborate to create a mutually encouraging environment for the advances of IM. CAM and IM publications and patents are reviewed. Evidence of their efficacy is generally lacking. Further research is needed.

Use of Complementary and Alternative Medicine Among Newly Diagnosed Breast Cancer Patients in Malaysia: An Early Report From the MyBCC Study.

Background. The use of complementary and alternative medicine (CAM) has increased and little is known on CAM use during the initial period. Therefore, the aim was to determine prevalence of CAM use among newly diagnosed breast cancer patients prior to seeking conventional treatment. Methods. This is a cross-sectional study involved interviewing newly diagnosed breast cancer patients in the University Malaya Medical Centre (UMMC) using a structured questionnaire. Eligible respondents were interviewedduring a routine clinical visit. Results. A total of 400 patients were interviewed, of whom 139 (34.8%) were CAM users. Dietary supplementation (n = 107, 77.0%) was the most frequently used type of CAM, followed by spiritual healing (n = 40, 28.8%) and traditional Chinese medicine (n = 32, 23.0%). Malay ethnic group (n = 61, 43.9%) was the largest group of CAM users, followed by Chinese (n = 57, 41.0%) and Indian (n = 20, 14.4%). Majority of these CAM users (n = 87, 73.1%) did not disclose the use of CAM to their doctors. Most of them used remedies based on the recommendation of family and friends. Malay ethnicity and patients with 3 or more comorbidities were more likely to use CAM. Conclusion. There is substantial use of CAM among breast cancer patients in UMMC prior to seeking hospital treatment, and the most popular CAM modality is dietary supplements. Since, the majority of CAM users do not disclose the use of CAM to their physicians, therefore health care providers should ensure that those patients who are likely to use CAM are appropriately counseled and advised.

“Do-it-yourself”: Vaccine rejection and complementary and alternative medicine (CAM)

In this article, we elucidate a symbiotic relationship between complementary and alternative medicine (CAM) and rejection of, or hesitancy towards, vaccination. In Fremantle, Western Australia, and Adelaide, South Australia, we conducted in-depth interviews from September 2013–December 2015 with 29 parents who had refused or delayed some or all of their children's vaccines. Our qualitative analysis found that for many, their do-it-yourself ethic and personal agency was enhanced by self-directed CAM use, alongside (sometimes informal) CAM practitioner instruction. Reifying ‘the natural,’ these parents eschewed vaccines as toxic and adulterating, and embraced CAM as a protective strategy for immune systems before, during and after illness. Users saw CAM as harm-free, and when it came to experiences that non-users might interpret as demonstrating CAM's ineffectiveness, they rationalised to the contrary. They also generally glossed over its profit motive. CAM emerged as part of an expert system countering Western medicine. CAM's faces were trusted and familiar, and its cottage capitalism appeared largely free from the taint of “Big Pharma.” A few parents employed a scientific critique of CAM modalities – and a minority were dubious of its profit motive – but others rejected the epistemology underpinning biomedicine, framing CAM as a knowledge not poisoned by avarice; a wisdom whose very evidence-base (anecdote and history) was demeaned by an arrogant scientific process only permitting belief in that which could be quantified. However, all parents engaged with Western medicine for broken bones and, sometimes, medical diagnoses. Our analysis suggests that pro-vaccination health professionals, policymakers and information-providers seeking to address the role of CAM in vaccine rejection face significant challenges due to the epistemic basis of some parents' decisions. However, we make some suggestions for professional practice and policy to enhance trust in vaccination.

The Use of Complementary and Alternative Medicine by the General Population in the Czech Republic: A Follow-Up Study

Background: The prevalence of complementary and alternative medicine (CAM) ranges between 0.3% and 86% in most highly developed countries. In the Czech Republic, CAM is used by 76% of the general population. Our aim was to examine patterns in CAM use among a representative sample of the general population in the Czech Republic, for 2011 and 2014. Material and Methods: A cross-sectional survey was conducted. A sex-, age- and region-stratified sample of citizens aged 15 years and older was randomly selected from the 2014 voter registration lists (n = 8,395,132). A comparative analysis of data collected in 2011 and 2014 was performed. Results: Overall, 76.0% (N = 1,365) versus 87.0% (N = 1,565) of the respondents reported use of 1 or more CAM modalities during the past 30 days, in 2011 and 2014, respectively (p < 0.001). In both years, the top 4 CAM modalities used were vitamins/minerals, herbal teas, massage, and relaxation. Yoga replaced dietary supplements excluding vitamins/minerals in the 5th position. Nevertheless, only herbal teas (48.0% vs. 53.0%, p = 0.002), massage (20.0% vs. 26.0%, p < 0.001), relaxation (10.0% vs. 19.0%, p < 0.001), and yoga (3.7% vs. 7.1%, p < 0.001) showed a significant increase in use. Conclusions: The prevalence of CAM use in the Czech Republic is increasing, especially among people who use biological, body- and mind-based CAM therapies. There is a great need to educate students and health care professionals about the efficacy and safety of CAM in order to meet the patients' demands on CAM.

Complementary and alternative medicine use among elderly patients living with chronic diseases in a teaching hospital in Ethiopia

BackgroundThe use of complementary and alternative medicine (CAM) among patients with chronic diseases has grown rapidly worldwide. Yet, little has been known about CAM use by elderly patients with chronic diseases in Ethiopia. This study aimed at assessing the prevalence and reasons for CAM utilization among elderly patients living with chronic diseases in Ethiopia. MethodsAn institution-based quantitative cross-sectional survey was conducted among elderly patients with chronic disease attending outpatient ambulatory clinics of University of Gondar referral and teaching hospital (UoGRTH). An interviewer-administered and semi-structured questionnaire were utilized to collect the data. ResultOf the total respondents, 240 (74%) reported the use of CAM, with herbal medicine and spiritual healing being the most commonly utilized CAM modalities (50.4% and 40.8% respectively). Dissatisfaction with conventional therapy (40.8%) and belief in the effectiveness of CAM (30.8%) are the most commonly cited reasons for the use of CAM therapies. Rural residency, higher educational status, higher average monthly income and presence of co-morbidity were positively associated with the use of CAM. ConclusionThis survey revealed a higher rate of CAM use among elderly patients with chronic diseases, along with a very low rate of disclosing their use to their health care providers. Special attention should be given for these patient population due to the potentially harmful interaction of different herbal remedies with the prescribed medications, thereby predisposing the patient to untoward adverse effects and compromised overall health outcome.

Knowledge, attitude, influences and use of complementary and alternative medicine (CAM) among chiropractic and nursing students

BackgroundComplementary and alternative medicine (CAM) is becoming more widely used in the community however there are differences in knowledge and attitudes among and within the various health professions. Chiropractic and nursing students represent a future generation of two health profession groups who may have differing views on CAM. The objectives of this study were to investigate the knowledge, attitudes and beliefs of nursing and chiropractic students about CAM. To investigate the factors that influence their attitudes and beliefs and their likelihood of recommending CAM; and to compare the findings between nursing and chiropractic students to determine similarities and differences.MethodsA modified and pre-tested survey including a previously validated 10-item CAM Health Belief Questionnaire (CHBQ) was administered to nursing and chiropractic students at Murdoch University. Student’s demographics were collected as well as other information regarding knowledge, attitudes, influences and use of CAM.ResultsThree hundred twenty-one nursing and 227 chiropractic students responded with a 91% response rate. The CHBQ overall mean scores for nursing and chiropractic students were 47.6 and 47.4 out of possible 70 respectively, confirming positive attitudes toward CAM in both groups. Nursing and chiropractic students also demonstrated similar knowledge levels. Factors that were most influential in shaping both chiropractic and nursing students’ attitudes and beliefs towards CAM were personal experience and the influence of external peers. Nursing students would not dissuade future patients from CAM, however chiropractic students were more likely to recommend CAM to their future patients.ConclusionsNursing and chiropractic students demonstrate relatively positive attitudes and beliefs towards CAM despite, their limited knowledge concerning CAM modalities generally.

Use of complementary and alternative medicine in Europe: Health-related and sociodemographic determinants.

Aims: The aim of this research was to study health-related and sociodemographic determinants of the use of different complementary and alternative medicine (CAM) treatments in Europe and differences in CAM use in various European countries. Methods: The study was based on a design-based logistic regression analysis of the European Social Survey (ESS), Round 7. We distinguished four CAM modalities: manual therapies, alternative medicinal systems, traditional Asian medical systems and mind-body therapies. Results: In total, 25.9% of the general population had used CAM during the last 12 months. Typically, only one CAM treatment had been used, and it was used more often as complementary rather than alternative treatment. The use of CAM varied greatly by country, from 10% in Hungary to almost 40% in Germany. Compared to those in good health, the use of CAM was two to fourfold greater among those with health problems. The health profiles of users of different CAM modalities varied. For example, back or neck pain was associated with all types of CAM, whereas depression was associated only with the use of mind-body therapies. Individuals with difficult to diagnose health conditions were more inclined to utilize CAM, and CAM use was more common among women and those with a higher education. Lower income was associated with the use of mind-body therapies, whereas the other three CAM modalities were associated with higher income. Conclusions: Help-seeking differed according to the health problem, something that should be acknowledged by clinical professionals to ensure safe care. The findings also point towards possible socioeconomic inequalities in health service use.

Survey of complementary and alternative medicine in pediatric inpatient settings

ObjectivesWhile use of complementary and alternative medicine (CAM) is common in children, we know little about its use for hospitalized children. This survey measured the rate of CAM use, specific modalities used, and policies related to CAM use for hospitalized children. DesignAnonymous survey of hospitals in the Pediatric Research in Inpatient Settings (PRĪS) network SettingHospitals in the PRĪS network. Main outcome measuresRate of overall and specific CAM modality use, including whether these modalities are provided, permitted, or prohibited, and presence of a written policy on CAM use. ResultsOf 99 sites queried, 22 responded. Of these, 82% of sites reported some CAM presence, and 63% reported official provision of CAM therapies. Freestanding children’s hospitals provided more modalities than other types of hospitals. There was no difference in number of modalities by geographic location. The most commonly provided CAM modalities were massage and biofield therapies. The most commonly prohibited modalities were inpatient placebos outside of research settings, medical marijuana, and inpatient homeopathic preparations. Only one site reported having a written policy on CAM use. ConclusionsAmong responding institutions, the most reported some CAM presence with a wide variety of CAM modalities provided and permitted. Written institutional policies on CAM were rare.

Complementary and alternative therapies in dentistry and characteristics of dentists who recommend them

ObjectivesThe aims of this study were to analyse whether dentists offer or recommend complementary and alternative medicine (CAM) remedies in their clinical routine, and how effective these are rated by proponents and opponents. A second aim of this study was to give a profile of the dentists endorsing CAM. DesignA prospective, explorative, anonymised cross-sectional survey was spread among practicing dentists in Germany via congresses, dental periodicals and online (n=250, 55% male, 45% female; mean age 49.1±11.4years). ResultsOf a set of 31 predefined CAM modalities, the dentists integrated plant extracts from Arnica montana (64%), chamomile (64%), clove (63%), Salvia officinalis (54%), but also relaxation therapies (62%), homeopathy (57%), osteopathic medicine (50%) and dietetics (50%). The effectiveness of specific treatments was rated significantly higher (p<0.0001) by CAM proponents than opponents. However also CAM opponents classified some CAM remedies as highly effective, namely ear acupuncture, osteopathic medicine and clove. For ear acupuncture these scores did not significantly differ between both groups. With respect to the characteristic of the proponents, the majority of CAM endorsing dentists were women. The mean age (50.4±0.9 vs 47.0±0.9years) and number of years of professional experience (24.2±1.0 vs 20.0±1.0years) were significantly higher for CAM proponents than the means for opponents (p<0.0001 respectively). CAM proponents worked significantly less (p<0.0001) and their perceived workload was significantly lower (p=0.008). Their self-efficacy expectation (SEE) and work engagement (Utrecht work engagement, UWE) were significantly higher (p≤0.01 and p<0.0001) compared to dentists who abandoned these treatment options. The logistic regression model showed (exploratively) an increased association from CAM proponents with the UWES subscale dedication, with years of experience, and that men are less likely to be CAM proponents than women. ConclusionVarious CAM treatments are recommended by German dentists and requested by their patients, but the scientific evidence for these treatments are often low or at least unclear. CAM proponents are often female, have higher SE and work engagement.

Use of Complementary and Alternative Medicine among Older Adults: Differences between Baby Boomers and Pre-Boomers

To compare use of complementary and alternative medicine (CAM) across age cohorts. Secondary analysis of data from the Collaborative Psychiatric Epidemiology Surveys. Adults born in 1964 or earlier (N = 11,371). Over half (61.3%) are baby boomers and 53% are female. Seventy-five percent of the sample is white, 10.2% African American, 0.6% black Caribbean, 9.35% Latino, and 4.1% Asian. The dependent variable is a dichotomous variable indicating use of any CAM. The main predictor of interest is age cohort categorized as pre-boomers (those born in 1945 or earlier) and baby boomers (those born between 1946 and 1964). Covariates include the use of traditional service providers in the past 12 months and 12-month levels of mood, anxiety, and substance disorder. Disorders were assessed with the Diagnostic and Statistical Manual World Mental Health Composite International Diagnostic Interview. Logistic regression was used to test the association between use of CAM and age cohort. Baby boomers were more likely than pre-boomers to report using CAM for a mental disorder. Among identified CAM users, a higher proportion of baby boomers reported using most individual CAM modalities. Prayer and spiritual practices was the only CAM used by more pre-boomers. Age cohort plays a significant role in shaping individual healthcare behaviors and service use and may influence future trends in the use of CAM for behavioral health. Healthcare providers need to be aware of patient use of CAM and communicate with them about the pros and cons of alternative therapies.

Complementary and Alternative Medicine Use Among US Adults With Headache or Migraine: Results from the 2012 National Health Interview Survey.

Given the safety concerns regarding pharmacological agents, and the considerable impact of headache and migraine on the sufferer's quality of life, many people seek other treatment options beyond conventional medication and care to address their symptoms; this includes complementary and alternative medicine (CAM). Some CAM interventions have shown promising results in clinical trials of headache and migraine management. Nonetheless, there has been little research exploring the reasons for using CAM, and the types of CAM used, among this population. The study aimed to answer the following questions: (1) Which CAM modalities are used most frequently among migraine/headache sufferers? and (2) What are the self-reported reasons for CAM use among migraine/headache sufferers? This secondary analysis of data from the 2012 U.S. NHIS (a national cross-sectional survey) examined the use of CAM among migraine/headache sufferers, including the main reasons related to CAM use. Data were weighted and analyzed using STATA 14.0. The sample of 34,525 adults included 6558 (18.7%) headache/migraine sufferers. Of the headache/migraine sufferers, a substantial proportion (37.6%, n = 2427) used CAM for various conditions; however, CAM use specifically for headache/migraine was much less prevalent (3.3%, n = 216). Of those who used CAM for headache/migraine, about half used CAM in conjunction with prescription (47.8%, n = 100) or over-the-counter medication (55.1%, n = 113). As severity of headache/migraine increased so did the likelihood of using CAM (severe migraine odds ratio [OR] = 2.32; 95% confidence interval [CI]: 1.41, 3.82; both recurring headache/severe migraine OR = 3.36; 95% CI: 2.08, 5.43; when compared to those with recurring headache only). The most frequently used CAM modality among all headache/migraine sufferers (N = 6558) was manipulative therapy (22.0%, n = 1317), herbal supplementation (21.7%, n = 1389) and mind-body therapy (17.9%, n = 1100). The top 3 reasons for using CAM for headache were general wellness (28.7%, n = 60/209), improving overall health (26.8%, n = 56/209), and reducing stress (16.7%, n = 35/209). Although CAM is used by many sufferers of headache/migraine, the use of CAM specifically for the treatment of headache/migraine is relatively low in the United States. The study also assesses the key differences of CAM use among headache/migraine sufferers in NHIS 2012 compared with those in NHIS 2007, and identifies shortfalls in the evidence-base of several CAM modalities used by U.S. adults for headache/migraine. This information may assist health providers and consumers in making informed decisions about the safest and most appropriate approach to managing headache/migraine.

Complementary and alternative medicine use and hormonal therapy initiation in women with hormone receptor-positive breast cancer: The BQUAL study.

e13097 Background: Use of complementary and alternative medicine (CAM) has been associated with initiation of breast cancer chemotherapy.We examined the association of CAM use with initiation of hormonal therapy in women with hormone receptor-positive (HR+) breast cancer. Methods: In aprospective cohort study designed to examine predictors of breast cancer treatment initiation and adherence, 699 women with non-metastatic stage I-III breast cancer and aged &lt; 70 years were recruited from Kaiser Permanente Northern California during 2006-2010. Baseline interviews assessed current use of five CAM modalities (dietary supplements: vitamins/minerals, herbs/botanicals, other natural products; mind/body therapies: mind-body self-practice, mind-body practitioner-based). Based on electronic pharmacy records, hormonal therapy initiation was defined as ≥2 prescriptions of ≥30 pills of any hormonal therapy drug within 1 year after diagnosis. Multivariable logistic regression analysis examined a priori hypotheses testing whether current CAM use was associated with hormonal therapy initiation, adjusted for demographic, tumor characteristics, and cancer treatment. Results: Of the 699 participants,552 were diagnosed with HR+ breast cancer. Among the 552 women with HR+ breast cancer, 494 (89%) used at least 1 modality of CAM, 414 (76%) used dietary supplements, and 391 (71%) used mind/body therapies. Within 1 year after diagnosis, 481 (87%) participants initiated hormonal therapy. The rate of initiation was comparable between CAM users and non-users (87% vs. 86%). In multivariable analyses, baseline overall CAM use was not associated with initiation of hormonal therapy. However, vitamins/minerals users were more likely to initiate hormonal therapy compared to non-users (OR = 1.87, 95% CI: 1.04, 3.51). Conclusions: CAM use was high among early stage HR+ breast cancer patients. Overall, use of CAM was not associated with hormonal therapy initiation. Current use of vitamins/minerals was associated with higher initiation rate of hormonal chemotherapy.

Factors related to the parallel use of complementary and alternative medicine with conventional medicine among patients with chronic conditions in South Korea

BackgroundThis study aims to examine the characteristics and behavioral patterns of patients with chronic conditions behind their parallel use of the conventional medicine (CM) and the complementary and alternative medicine (CAM) that includes traditional Korean Medicine (KM). MethodsThis cross-sectional study used the self-administered anonymous survey method to obtain the results from inpatients who were staying in three hospitals in Gyeongnam province in Korea. ResultsOf the 423 participants surveyed, 334 participants (79.0%) used some form of CAM among which KM therapies were the most common modalities. The results of a logistic regression analysis showed that the parallel use pattern was most apparent in the groups aged over 40. Patients with hypertension or joint diseases were seen to have higher propensity to show the parallel use patterns, whereas patients with diabetes were not. In addition, many sociodemographic and health-related characteristics are related to the patterns of the parallel use of CAM and CM. ConclusionIn the rural area of Korea, most inpatients who used CM for the management of chronic conditions used CAM in parallel. KM was the most common in CAM modalities, and the aspect of parallel use varied according to the disease conditions.

Comparing Complementary and Alternative Medicine Use with or without Including Prayer as a Modality in a Local and Diverse United States Jurisdiction.

Few studies to date have examined the utilization of complementary and alternative medicine (CAM) in a local, ethnically diverse population in the United States (U.S.). Fewer have addressed the differences in their use based on inclusion or exclusion of prayer as a modality. Variable definitions of CAM are known to affect public health surveillance (i.e., continuous, systematic data collection, analysis, and interpretation) or benchmarking (i.e., identifying and comparing key indicators of health to inform community planning) related to this non-mainstream collection of health and wellness therapies. The present study sought to better understand how including or excluding prayer could affect reporting of CAM use among residents of a large, urban U.S. jurisdiction. Using population-weighted data from a cross-sectional Internet panel survey collected as part of a larger countywide population health survey, the study compared use of CAM based on whether prayer or no prayer was included in its definition. Patterns of CAM use by socio-demographic characteristics were described for the two operationalized definitions. Multivariable binomial regression analyses were performed to control for gender, age, race/ethnicity, education, employment, income, and health insurance status. One of the analyses explored the associations between CAM use and racial/ethnic characteristics in the study sample. Los Angeles County, California. A socio-demographically diverse sample of Los Angeles County residents. CAM use (with prayer) and CAM use (excluding prayer). Blacks were among the highest users of CAM when compared to Whites, especially when prayer was included as a CAM modality. Regardless of prayer inclusion, being a woman predicted higher use of CAM. How CAM is defined matters in gauging the utilization of this non-mainstream collection of therapies. Given that surveillance and/or benchmarking data are often used to inform resource allocation and planning decisions, results from the present study suggest that when prayer is included as part of the CAM definition, utilization/volume estimates of its use increased correspondingly, especially among non-White residents of the region.