Complementary And Alternative Medicine Therapies Research Articles

Dietary Supplement Based Complementary and Alternative Medicine Use in Pediatric Autism: Physician Based Perception, Knowledge and Involvement

BackgroundAutism spectrum disorder (ASD) is a group of heterogeneous chronic neurodevelopmental disorders characterized by qualitative impairments in social interaction, communication, and repetitive stereotyped patterns of behavior, and is quoted as being the fastest growing developmental disorder in the United States affecting an estimated 1 in 45 children. In addition to conventional treatment options, some parents of children with autism seek out supplement based complementary and alternative medicine (CAM) to treat autistic symptoms.PurposeThis study describes the use of CAM in children between the ages of 4 to 14 years with and without ASD. Data from this study aims to: (1) provide a more clear understanding of the prevalence and types of supplement therapies used; (2) increase awareness of the use of CAM therapies in children to provide better integrative care; (3) inform public health professionals of common and potentially harmful CAM therapies in ASD to guide public initiatives; and (4) assess patient‐physician communication and interactions surrounding CAM use.MethodologyThis population‐based, survey sample evaluated children with and without ASD (4 to 14 years) in regards to supplement use. Participants were recruited from educational and physical activity programs to complete a questionnaire. Primary caregivers provided information on current CAM use and their perceived physician knowledge of CAM administration. Data evaluates the proportion of children that use supplement therapies, the types of supplements used, reasons for use, perceived safety, and demographic factors associated with use (e.g. income, parental education, severity of disorder). In a second, follow‐up survey, physicians of children were asked to answer a questionnaire on CAM use in their patients‐‐. In particular, it examined the relationship between the parent and child's physician in terms of perceived parental and physician comfort in discussing supplements, parental disclosure of supplements, and physician knowledge of autism and supplements.ResultsPreliminary results indicate that 50% of children with ASD are taking supplements, compared to only 33% of children without ASD. The most common supplement used was a multivitamin (46%), the use of polyunsaturated fatty acids (PUFAs), B vitamins, and dietary fiber use were also found. Health care professionals were the most common information source regarding supplements and the majority of parents reported disclosing all supplement use to their child's primary health provider. All parents, both in the autism and control group, indicated that they perceived supplements as being safe. In conclusion, the use of supplement therapies in children with ASD is common and highlights the need for further research with respect to treatment communication, knowledge, and education.Support or Funding InformationAlberta Children's Hospital Research Institute.This abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

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.

Management of Depression, Part 2: Treatment Options

Clinical depression is a commonly occurring and profoundly disabling condition that affects approximately 4%, or nearly 350 million people, worldwide according to the World Health Organization. Managing depression is challenging due to the marked variability in biological contributors, the heterogeneity of the illness, psychosocial history, current stresses exacerbating the condition, medical and psychiatric co-occurring conditions, lifestyle, and motivation and willingness to accept and engage in treatment recommendations. Mental health professionals such as master-level counselors, psychologists, or psychiatrists are specially trained to identify and treat depression; however, a significant amount of depression presents in primary care medical settings. This review covers treatment of depression with psychotherapy, complementary and alternative medicine (CAM), and antidepressant medication, as well as treatment course and long-term depression treatment. Tables list CAM depression treatments, nonnutraceutical CAM therapies, managing antidepressant side effects, tricyclic antidepressants, serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, norepinephrine dopamine reuptake inhibitor, alpha2 antagonists, serotonin-2 antagonist/reuptake inhibitors, monoamine oxidase inhibitors, food restrictions with monoamine oxidase inhibitors, managing partial response/treatment-resistant depression, and serotonin receptor modulators. This review contains 15 tables and 98 references Key words: antidepressant medication, clinical depression, depression, monoamine oxidase inhibitors, nonpharmacologic depression treatment, omega-3 fatty acids, S-adenosylmethionine, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, St. John’s wort, tricyclic antidepressants

Complementary and Alternative Medicine use: Influence of Patients’ Satisfaction with Medical Treatment among Breast Cancer Patients at Uganda Cancer Institute

Introduction: Use of Complementary and alternative medicine (CAM) is high among cancer patients especially breast cancer patients. This study sought to evaluate Complementary and alternative medicine use in breast cancer patients and how its use is influencedby patient’s satisfaction with conventional medical treatment among breast cancer patients attending Uganda Cancer Institute. Patients and Methods: A cross-sectional study design was used in this study. Participants who were diagnosed histologically with breast cancer at Uganda Cancer Institute took part in the study. A questionnaire was developed and used to interview the participants and medical records of the respondents were also reviewed. Results: A total of 235 participants completed the study. The prevalence of CAM use was 77%. CAM therapies used included herbal medicines, prayer for health, vitamins/minerals, native healers, Chinese medicines, massage, yoga, Ayurvedic medicine, Acupuncture, reflexolog, Support group attendance, meditation, Magnetic and Bio-fieldmanipulation. Satisfaction with medical treatment was significantlyassociated with CAM use. Patients who are not satisfiedwith medical treatment were more likely to use CAM. Conclusion: There is a high number of breast cancer patients using CAM, various categories of therapies are being used and patients’ satisfaction with medical treatment triggers off a patients decision to use CAM therapies.

Factors associated with insomnia and complementary medicine use in children: results of a national survey

ObjectivesSleep difficulties are a serious health problem in children, and interest in using complementary and alternative medicine (CAM) therapies to treat sleep is growing. In this study, we aimed to identify: the prevalence of sleep difficulties in children, and the prevalence and patterns of CAM use among children with trouble sleeping. MethodsWe used the 2012 National Health Interview Survey (NHIS) dataset to estimate the prevalence of sleep difficulties and CAM use in children ages 6–17 years. Prevalence estimates were weighted to reflect the survey's sampling design. We used logistic regression to explore associations between sleep difficulties, psychosocial factors, comorbidities and CAM use. Results6.4% of children in the 2012 NHIS dataset reported regular difficulty sleeping in the last year, corresponding to an estimated 1.5 million children in the US. Older age, poorer health status, more missed school days, and multiple comorbidities were all associated with sleep difficulties (p ≤ 0.001). Among children with sleep difficulties, 29% used at least one CAM therapy. Of the CAM therapies surveyed, non-vitamin, non-mineral supplements were the most commonly used (14.6%), followed by manipulation therapies (9.2%) and mind-body techniques (8.8%). Parental education and CAM use were most strongly associated with child CAM use (p ≤ 0.001). ConclusionsCAM therapies, particularly non-vitamin, non-mineral supplements, are commonly used among children with sleeping problems. More research is needed to characterize the safety and efficacy of CAM therapies for sleep in this population.

Parents’ Strategies of Managing Minor Childhood Illnesses Using Complementary and Alternative Medicine in Jordan

BACKGROUND: Complementary and Alternative Medicine (CAM) is a group of medical products and practices that are not part of conventional medicine.METHOD: The aims of this study were to identify the strategies of managing minor illnesses, perceptions and significant predictors of using CAM among Jordanian parents. A cross-sectional descriptive design was used. The study was conducted in ten Ministry of Health comprehensive health centers in Jordan. A convenience sample of 328 participants was recruited and asked to complete a self-report structured questionnaire.RESULTS: Over 80% of study participants used CAM to treat minor illness for their children. Digestive system problems, upper respiratory tract infection, and urinary tract infection were the most common managed illnesses. Herbs, prayer, and aromatherapy were the most common types of CAM therapy. The most common reasons for using CAM were making the child comfortable, supporting medical treatment, and promoting health and preventing disease. The major sources of advice were self, mother or mother in law, and friend. 72% of CAM users reported that they always consulted their health care providers about CAM use. More than 60% of the study sample perceived CAM as complementary, safe, and efficient. Finally, CAM belief, father’s education, and living with extended family significantly predicted CAM use.CONCLUSION: Health care providers in general should be able to assess CAM use, provide accurate health education and encourage parents to consult their health care providers about CAM use.

Integrative medicine or infiltrative pseudoscience?

Evidence-based medicine, first described in 1992, offers a clear, systematic, and scientific approach to the practice of medicine. Recently, the non-evidence-based practice of complementary and alternative medicine (CAM) has been increasing in the United States and around the world, particularly at medical institutions known for providing rigorous evidence-based care. The use of CAM may cause harm to patients through interactions with evidence-based medications or if patients choose to forego evidence-based care. CAM may also put financial strain on patients as most CAM expenditures are paid out-of-pocket. Despite these drawbacks, patients continue to use CAM due to media promotion of CAM therapies, dissatisfaction with conventional healthcare, and a desire for more holistic care. Given the increasing demand for CAM, many medical institutions now offer CAM services. Recently, there has been controversy surrounding the leaders of several CAM centres based at a highly respected academic medical institution, as they publicly expressed anti-vaccination views. These controversies demonstrate the non-evidence-based philosophies that run deep within CAM that are contrary to the evidence-based care that academic medical institutions should provide. Although there are financial incentives for institutions to provide CAM, it is important to recognize that this legitimizes CAM and may cause harm to patients. The poor regulation of CAM allows for the continued distribution of products and services that have not been rigorously tested for safety and efficacy. Governments in Australia and England have successfully improved regulation of CAM and can serve as a model to other countries.

Convergent priorities and tensions: a qualitative study of the integration of complementary and alternative therapies with conventional cancer treatment.

Demand for complementary and alternative medicine (CAM) is high among cancer patients. This, alongside growing evidence for the efficacy of some CAM therapies, is driving change within cancer centres, where evidence-based CAM therapies are increasingly provided alongside standard cancer treatments. In Australia, commitment to equitable access to healthcare is strong, and some cancer centres are now providing integrative services at no cost to the patient. This represents a significant shift in healthcare provision. This study aimed to examine health professional and patient dynamics in an integrated cancer service where CAM is provided at no cost to patients alongside standard cancer treatments. It specifically sought to understand what might drive or hinder further integration of CAM with standard treatment in the cancer context. Qualitative interviews were undertaken with twenty key stakeholders-cancer patients, cancer nurses, and oncologists-who were delivering or receiving care in an Australian public hospital where acupuncture services are provided at no cost to patients alongside standard chemotherapy and radiation treatments. Findings point to key areas where the concerns and priorities of cancer patients, cancer nurses, and oncologists converge and diverge in ways that reflect core personal and professional interests regarding patient care needs, the evidence base for CAM efficacy and safety, and rising healthcare costs. Understanding points of convergence and divergence could assist clinicians and service providers in negotiating ways forward for integrative cancer services.

Blood-letting therapy for the common cold: A protocol for a systematic review of controlled trials.

Background:Many people experience the common cold, but there is currently no special treatment. For this reason, complementary and alternative medicine (CAM) therapies are used to improve the symptoms of the common cold. Blood-letting therapy (BL) is a CAM therapy that has been used for over 2000 years to treat various diseases. However, few studies have provided evidence for the efficacy and safety of BL for the common cold. This study aims to assess the effectiveness and safety of BL for the common cold.Methods and analysis:A total of 11 databases will be searched for studies conducted through June 2017. We will include randomized controlled trials assessing BL for the common cold. All randomized controlled trials on BL or related interventions will be included. Risk of bias will be assessed using the Cochrane Risk of Bias Assessment Tool, while confidence in the accumulated evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument.Ethics and dissemination:This systematic review will be published in a peer-reviewed journal and will also be disseminated electronically and in print. The review will be updated to inform and guide healthcare practices.

Use of ethnic spices by adults in the United States: An exploratory study.

Background: The use of complementary and alternative medicine (CAM) therapies has increased in the United States, but little is known about consumers’ perceptions of use of such therapies. The purpose of this study was to assess knowledge, perceptions, and predictors of spice use for health promotion among adults in the Midwestern US.Methods: UUsing a cross-sectional study design, adults in the Midwestern US (n = 703) completed a valid and reliable survey which was pilot tested with a small convenience sample of adults (n = 38). The study variables included demographic profile, spice use behavior, perceptions about efficacy of spices, and willingness to use spices. Data were analyzed using SPSS to compute descriptive (e.g. percent and frequencies) and inferential statistics (i.e. logistic regression analyses).Results: Almost half of the participants were interested in learning about health benefits of spices (48%), indicated friends and family members as sources of information on spices (50%),and were willing to use spices as CAM therapies (51%). Most (>50%) of the participants were familiar with or had used eight out of the 10 listed spices. The majority of participants (54%)were currently using one or more spices on a daily basis and believed that ginger (64%), garlic(58%), and cinnamon (56%) could promote good health and wellness. In logistic regression analysis, age, gender (odds ratios [OR] = 1.44 and OR = 1.56), income (OR = 1.77), health status(OR = 2.01), and recommendations from healthcare providers (OR = 5.31 and OR = 3.96) were significant predictors of current spice use and willingness to use spices.Conclusion: Individuals in our study did not use many ethnic spices and were unaware of potential health benefits of spices. Greater awareness of ethnic spices for disease prevention and health promotion are needed in this population.

Pattern of complementary and alternative medicine use in pediatric oncology patients in a South Indian hospital

BackgroundEven though the use of complementary and alternative medicines (CAMs) is thought to be more prevalent among pediatric cancer patients, no studies have been reported on a South Indian population. ObjectivesThis study aimed to investigate the prevalence of the use of CAMs among pediatric cancer patients in a tertiary care South Indian hospital. Patients and methodsTwo hundred and seventy-seven pediatric cancer patients who received conventional therapy for the treatment of various types of cancer were enrolled from a pediatric oncology department in South India. ResultsOf the enrolled children, 7.58% used CAMs, of which the most commonly used was Ayurveda followed by Siddha. Most of the CAM users were upper middle class. There were no statistically significant differences between the usage of CAMs and baseline characteristics except for socioeconomic status. None of the parents of the enrolled children disclosed their CAM treatment to an oncologist. ConclusionParents must be educated about CAM therapy and advised to discuss all treatment-related issues with an oncologist. Pharmacists can play a bridging role between oncologists and parents, and other healthcare professionals should also be familiar with the benefits and disadvantages of using CAM therapy to be able to guide the parents.

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.

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.

Botanical Complementary and Alternative Medicine for Pruritus: a Systematic Review

Complementary and alternative medicine (CAM) is widely used by patients who suffer from chronic pruritus, but there is little data on the efficacy or antipruritic mechanism of these interventions. This review assesses the current understanding of the clinical efficacy and purported mechanisms of CAM therapy for pruritic skin disease, and serves as a basis for further investigation into the pharmacological basis of plant-based CAM for pruritus and patient motivations in the adoption of these types of therapies. To assess the current state of the literature, we queried multiple databases for reports of botanical CAM therapies for pruritic skin conditions. Numerous in vitro and animal studies show positive results, but antipruritic effects in human trials are varied. Many of these topical and systemic therapies have demonstrated measurable impact on inflammatory pathways, including some that are known to be crucial in transmission of itch signaling. CAM is a frequently utilized but somewhat poorly understood intervention for chronic pruritus, though our understanding of the impact of these therapies on pruritus has improved in recent years. Further studies into the mechanism and efficacy of CAM-based therapies for chronic pruritus, and patient attitudes towards these practices, are warranted.

Complementary and Alternative Medicine Use in Minority and Medically Underserved Oncology Patients: Assessment and Implications.

Introduction: Complementary and alternative medicine (CAM) use in minority and medically underserved oncology patients is not well documented. We assessed knowledge and utilization of CAM in a sample of these patients receiving treatment at an urban community hospital. Methods: Patients with cancer were interviewed using an electronic application that depicted specific CAM therapies. Patients were questioned on their knowledge and utilization of therapies, deterrents to use, and interest in using these therapies if they were made available. Results: Patients (n = 165) reported a high awareness and use of CAM therapies. CAM use was highest for prayer (85%), relaxation (54%), special diet (29%), meditation (19%), and massage (18%). Patients’ interest in using CAM was high for nearly all therapies. Lack of adequate knowledge and cost of use were reported as deterrents to use. Female patients reported higher use of aromatherapy relative to males (37.1% vs 19.4%, P = .02); those with higher education reported greater use of relaxation (60.8% vs 28.6%, P = .02); non-Hispanics reported higher use of relaxation relative to Hispanics (63.5% vs 44.2%, P = .03), and African American patients reported higher use of relaxation relative to White patients (69.2% vs 50%, P = .03). Conclusions: CAM use in minority and medically underserved cancer patients is common, but not professionally guided; thus, concerns remain regarding its safe use. Our data underscore the importance of patient-physician dialogue regarding CAM use in this patient population, and interest in access to the medically guided integration of evidence-based CAM therapies.

A truly complementary approach: A qualitative exploration of complementary and alternative medicine practitioners' views of treating ankylosing spondylitis.

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease in which individuals experience a long delay to diagnosis. Prior to diagnosis, individuals report frequent use of complementary and alternative medicine (CAM) therapies. While popularly used, there is a dearth of knowledge concerning the experiences of CAM practitioners in terms of treating individuals with AS. Addressing this knowledge gap, the present study provides a detailed exploration of how UK-based CAM practitioners treat individuals with AS. Semi-structured telephone interviews were conducted with eight UK-based CAM practitioners, (four males), aged 45-69years. CAM practitioners were recruited across a range of CAM therapies and years of CAM practice experience (8-46years). Thematic analysis resulted in the identification of three themes to characterize the data. Themes comprised: (i) the whole picture; (ii) alarm bells; and (iii) a common language. Themes highlighted CAM practitioner adoption of a holistic, yet individualized approach to treating individuals with AS, despite a general sense of lack of knowledge concerning AS among CAM practitioners. Notably, results indicated a desire of CAM practitioners to work more collaboratively with mainstream health providers to provide more joined-up care for individuals with AS. CAM practitioners emphasized the benefits of CAM to focus on providing effective symptom management when used in conjunction, rather than in opposition to, mainstream healthcare. Adoption of a more holistic approach to AS management by CAM practitioners may empower clients to become more aware of symptoms, thus potentially reducing delays in receiving a formal diagnosis of AS.

Inpatients' Preferences, Beliefs, and Stated Willingness to Pay for Complementary and Alternative Medicine Treatments

Objectives: Research demonstrates the benefits of complementary and alternative medicine (CAM) in myriad environments. Yet, the majority of CAM services are offered in outpatient settings. Incorporating CAM into hospital settings may lead to increased patient comfort, well-being, and overall satisfaction with hospital admissions. Few studies have examined CAM services among inpatients. Therefore, this study assessed inpatients' preferences and beliefs regarding CAM, as well as their stated willingness to pay for these services. Design: Adult patients (n = 100), ranging in age from 19–95 years (M = 53 years; SD = 19.2 years), were recruited during their hospitalization in the University of California, San Diego, Healthcare System. The inpatients completed a brief individual interview to gather their perspectives on common CAM services, including acupuncture, aromatherapy, art therapy, guided imagery, healthy food, humor therapy, massage therapy, music therapy, pet therapy, Reiki, and stress management. Inpatients were asked which CAM therapies they perceived as being potentially the most helpful, their willingness to pay for those therapies, and their perceived beliefs regarding the use of those therapies. Results: Inpatients most commonly perceived healthy food (85%), massage therapy (82%), and humor therapy (70%) to be the most helpful, and were most willing to pay for healthy food (71%), massage therapy (70%), and stress management (48%). Inpatients most commonly believed CAM treatments would provide relaxation (88%), increase well-being (86%), and increase their overall satisfaction with the hospitalization (85%). Conclusions: This study suggests that CAM services may be a beneficial addition to hospitals, as demonstrated by inpatients' interest and stated willingness to pay for these services. These findings may help organizational leaders when making choices regarding the development of CAM services within hospitals, particularly since a significant percentage of inpatients reported that CAM services would increase their overall satisfaction with the hospitalization. These results merit further attention given the need to increase cost savings while enhancing the overall patient experience in today's medical marketplace.

Risk of anaphylaxis in complementary and alternative medicine.

Complementary and alternative medicine (CAM) use is widespread across the world. Patients with asthma and allergy regularly use CAM therapies. Allergic and anaphylactic reactions to CAM have been reported. Recent attempts to regulate and monitor adverse reaction to these therapies have given us further insight into potential causes of severe allergic reactions. Several culprits identified including Andrographis paniculata, Echinacea species, bee products, Ginkgo biloba and Ginseng are discussed here. Knowing the factors that increase the risk of anaphylaxis allows reactions to be recognized, reported and further investigated. Research to identify key causative allergens is necessary in the future. Collaboration between the allergy community and CAM practitioners can allow better understanding of allergy to these therapies.

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.

Prevalence, patterns, and perceived value of complementary and alternative medicine among HIV patients: a descriptive study

BackgroundUse of complementary and alternative medicine (CAM) is widespread among different patient populations despite the availability of evidence-based conventional medicine and lack of supporting evidence for the claims of most CAM types. This study explored the prevalence, patterns, and perceived value of CAM among human immunodeficiency virus (HIV) patients.MethodsThis quantitative descriptive study was conducted between November 1, 2014 and March 31, 2015 among a cross-sectional, convenience sample of attendees of the HIV clinic of a public tertiary health care institution. Face-to-face interviews using a 34-item questionnaire were conducted. Data analysis included descriptive statistics, chi-square tests, and binary logistic regression analysis.ResultsCAM was used by 113 (32.8%) of a total of 343 HIV patients, but <1% informed their health care providers of CAM usage. Medicinal herbs were the most common type of CAM used (n = 110, 97.3%) followed by spiritual therapy (n = 56, 49.6%), including faith healing/prayer and meditation. The most used medicinal herbs were Aloe vera (n = 54, 49.1%), ginger (n = 33, 30.0%), and garlic (n = 23, 20.9%). The most used vitamins were complex B vitamins (n = 70, 61.9%), followed by vitamin A (n = 58, 51.3%), vitamin E (n = 51, 45.1%), and vitamin D (n = 42, 37.1%). Most CAM users continued using conventional medicine in addition to CAM and were willing to use CAM without supervision and without informing their health care provider. Patients were generally satisfied with CAM therapy (n = 91, 80.5%). The main reasons for CAM use were the desire to take control of their treatment (8.8%) or just trying anything that could help (18.8%). Main influences were the mass media (32.7%) and non-hospital health personnel (19.5%). Predictors of CAM use were being 30–50 years, married and having a secondary school education.ConclusionAbout one-third of HIV patients used CAM, but virtually none informed their healthcare provider. Medicinal herbs were the most common type of CAM, followed by spiritual therapy and vitamins. A patient’s decision to use CAM was influenced for the most part by the mass media and non- hospital health care personnel.