Complementary And Alternative Medicine Therapies Research Articles

385 Complementary and alternative medicine (CAM) use in patients with cutaneous lymphoma

Primary cutaneous lymphomas are a group of rare non-Hodgkin lymphomas that can cause significant morbidity and adversely affect patients’ quality of life (QoL). Complementary and alternative medicine (CAM) includes therapies that are not part of traditional Western medical care. CAM therapies have demonstrated potential benefits in both cancer and skin disease, however, there are few studies examining patterns of CAM use among patients with cutaneous lymphoma (CL). We performed a cross-sectional study assessing CAM use and QoL in patients with CL via an electronic survey administered to patients via the Cutaneous Lymphoma Foundation from February-April 2019. A total of 300 patient responses (67% female, mean age 57y) were included in analysis. The most common type of CL among respondents was mycosis fungoides (84%, n=246), followed by Sézary Syndrome (12%, n=35). A majority (58%) of patients reported using CAM for their CL, with 48% using CAM to treat their disease and 46% using CAM to manage their symptoms. The most commonly used CAM in our cohort were vitamins/minerals (32%), prayer/meditation (26%), diet (24%), and exercise/yoga (22%). QoL as assessed by the Skindex-16 and Functional Assessment of Cancer Therapy-General (FACT-G) was worse among patients who reported CAM use; Skindex scores were 51 ± 27 among CAM users compared to 38 ± 26 for non-CAM users (p<0.001). Higher itch scores were reported by patients using CAM compared to non-users (37 ± 29 and 26 ± 26 respectively; p=0.002). CAM use is common among patients with CL, and CAM use is higher among those with worse itching and worse QoL.

Is the use of alternative therapy in children just another form of medicalisation? A prospective study.

The use of complementary and alternative medicines (CAM) seems widespread in adults and children, despite the conflicting evidence regarding its effectiveness and safety. This study aims to investigate the prevalence of the use of CAM in a population of Italian children. This is a prospective observational study conducted in 4 family paediatric clinics, in Friuli Venezia Giulia, Italy, from February to June 2019. Children were enrolled after being visited. The use of CAM and essential therapies (ET) in the previous year was investigated with an anonymous questionnaire. The demographic characteristics of children and families were also collected. Six hundred children were enrolled, mean age 5.8years, 50% females. In the previous year, 358 (60%) children used both essential therapies and CAM, 209 children (35%) only essential therapies, 25 (4%) only CAM, and 8 (1%) no therapy. CAM was more frequently used in children whose parents have a higher educational level and come from high-income countries (P<.0001). Non-vaccinated children received more CAM than vaccinated ones (P<.003). In our population, more than 60% of children receive CAM. The use of this medical approach seems strictly related to the social and cultural status of families.

Prevalence of complementary and alternative medicine use in brain tumor patients at King Abdulaziz University Hospital, Jeddah, Saudi Arabia.

Objectives:To determine the prevalence and types of complementary and alternative medicine (CAM) being utilized and the possible factors that prompted the use of CAM in patients with brain tumors.Methods:The study conducted was a questionnaire-based, cross-sectional study of patients diagnosed with brain tumors at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia from January 2011 to May 2018. Patients with primary and secondary brain tumors, were included. Our questionnaire was conducted via phone interviews after obtaining patient consent.Results:A total of 72 patients were included. The mean age of the participants was 45.89 (±16.52) years. We found that education level significantly affected the use of CAM. Fewer users of CAM held bachelor’s degree and patients with lower degrees used CAM more frequently (p=0.027). The most frequent types of CAM were Zamzam (holy water) and Ruqya (Quran reading). Family members were the most frequent source of information about the use of CAM (81.6%).Conclusion:Education level has a significant effect on CAM use. Gender plays a role in the type of CAM used. Future research should focus on the adverse effects of some CAM therapies, how effective CAM therapies are, and the effect CAM may play in delaying patients from seeking medical advice.

Pengaruh Pemberian Edukasi Terhadap Pengetahuan Complementery Alternative Medicine (CAM) Pada Penderita HIV di Jambi

&lt;h1&gt;ABSTRACT&lt;/h1&gt;&lt;h1&gt; &lt;/h1&gt;&lt;p&gt;&lt;strong&gt;Background &lt;/strong&gt;: HIV / AIDS is a public health problem that needs serious attention from the government. Besides to conventional medicine people with HIV / AIDS often use complementary and alternative medicines (CAM) in order to increase the qualityhealth. Complementary and alternative medicine (CAM) uses natural ingredients, not only restricted to herbal plants, but also includes the use of other natural vitamins and minerals. Compared to conventional treatments, CAM therapy is more save to use because it does not cause serious side effects. The purpose of this study was to know what are the effects of providing CAM education to ODHA at the Jambi Kanti Sehati Sejati Foundation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method&lt;/strong&gt;:This research was a quasi-experimental one type pretest-posttest type of research and is a type of quantitative descriptive study with prospective data collection. There were 35 ODHA who were respondents in this study and registered as members of the Jambi Kanti Sehati Sejati Foundation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;R&lt;/strong&gt;&lt;strong&gt;esults&lt;/strong&gt;: on demographic characteristics and CAM knowledge were obtained from questionnaires that given before and after giving the education, and proved by paired T test so that significance values ≤ 0.05 were obtained.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclution &lt;/strong&gt;:there is the influence of education on CAM knowledge in HIV suffererof.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;Keywords:Alternative and Complementary Medicine, CAM, HIV / AIDS.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;

The Perceived Credibility of Complementary and Alternative Medicine: A Survey of Undergraduate and Graduate Students

ABSTRACT The popularity of complementary and alternative medicine (CAM) appears to be increasing, especially among college students. We surveyed 146 undergraduate and graduate students with the CAM Health Belief Questionnaire and obtained credibility and frequency ratings for a select group of CAM therapies: yoga, meditation, massage, chiropractic medicine, biofeedback, hypnosis, acupuncture, spirituality/religion, therapeutic touch, the use of herbs/vitamins, and aromatherapy/essential oils. Graduate students held more favorable views about integrating CAM into conventional medical practice. Female students reported using a wider variety of therapies than male students. Spirituality/religion and herbs/vitamins were the most popular CAM approaches. Students rated yoga, meditation, and massage as being highly credible practices. They rated hypnosis and therapeutic touch low in credibility. We discuss hypnosis as an example of a therapy that suffers from poor public perception despite having a relatively strong evidentiary base.

A scoping review of network meta-analyses assessing the efficacy and safety of complementary and alternative medicine interventions

BackgroundNetwork meta-analysis (NMA) has rapidly grown in use during the past decade for the comparison of healthcare interventions. While its general use in the comparison of conventional medicines has been studied previously, to our awareness, its use to assess complementary and alternative medicines (CAM) has not been studied. A scoping review of the literature was performed to identify systematic reviews incorporating NMAs involving one or more CAM interventions.MethodsAn information specialist executed a multi-database search (e.g., MEDLINE, Embase, Cochrane), and two reviewers performed study selection and data collection. Information on publication characteristics, diseases studied, interventions compared, reporting transparency, outcomes assessed, and other parameters were extracted from each review.ResultsA total of 89 SR/NMAs were included. The largest number of NMAs was conducted in China (39.3%), followed by the United Kingdom (12.4%) and the United States (9.0%). Reviews were published between 2010 and 2018, with the majority published between 2015 and 2018. More than 90 different CAM therapies appeared at least once, and the median number per NMA was 2 (IQR 1–4); 20.2% of reviews consisted of only CAM therapies. Dietary supplements (51.1%) and vitamins and minerals (42.2%) were the most commonly studied therapies, followed by electrical stimulation (31.1%), herbal medicines (24.4%), and acupuncture and related treatments (22.2%). A diverse set of conditions was identified, the most common being various forms of cancer (11.1%), osteoarthritis of the hip/knee (7.8%), and depression (5.9%). Most reviews adequately addressed a majority of the PRISMA NMA extension items; however, there were limitations in indication of an existing review protocol, exploration of network geometry, and exploration of risk of bias across studies, such as publication bias.ConclusionThe use of NMA to assess the effectiveness of CAM interventions is growing rapidly. Efforts to identify priority topics for future CAM-related NMAs and to enhance methods for CAM comparisons with conventional medicine are needed.Systematic review registrationhttps://ruor.uottawa.ca/handle/10393/35658

How German general practitioners justify their provision of complementary and alternative medicine \u2013 a qualitative study

BackgroundMany German general practitioners (GPs) use complementary and alternative medicine (CAM) in their daily work although most CAM procedures are controversial from an academic point of view.ObjectiveWe aimed to investigate how GPs justify their use of CAM.MethodsWe performed semi-structured, individual face-to-face interviews with 20 purposively sampled, experienced GPs providing primary care within the framework of the German statutory health insurance system. A grounded theory approach was used for data analysis.ResultsAll GPs participating in this study used at least some CAM in their clinical practice. Participants did not have any major conflicts when justifying their use of CAM therapies. Important arguments justifying CAM provision were: using it as a supplementary tool to conventional medicine; the feeling that evidence and science leave many problems in primary care unanswered; a strong focus on helping the individual patient, justifying the use of procedures not based on science for therapeutic and communicative purposes; a strong belief in one’s own clinical experience; and appreciation of placebo effects. In general, participants preferred CAM therapies which seemed at least somewhat plausible to them and which they could provide in an authentic manner.ConclusionsOur results suggest that many German GPs integrate CAM treatments in their routine primary care work without perceiving any major internal conflicts with professional ideals.

Scientific Appearance and Homeopathy. Determinants of Trust in Complementary and Alternative Medicine

ABSTRACT Several studies have investigated the motivations driving the use of complementary and alternative medicines (CAM). Nevertheless, the general public view of these therapies remains relatively unexplored. Our study identifies the social factors that determine a person’s trust in alternative therapies, like homeopathy or acupuncture, drawing conclusions from the results of the Spanish National Survey on the Social Perception of Science and Technology (N = 6,357). We show that trust in the effectiveness of CAM therapies is not mutually exclusive with a belief in science for the general public, pointing to a certain level of disinformation. The comparison with superstitions confirms a clear differentiation with the drivers of trust in analyzed CAM therapies. We argue that scientific appearance of these alternative therapies, in terms of prescription, communication and marketing, may play an important role in determining trust in them for a large part of the population. Furthermore, we confirm that women and those with higher socio-economic status are more likely to express trust in the effectiveness of CAM therapies. Additionally, distrust of the influence of big pharma on health policies seems to have an effect on viewing CAM therapies as more effective. Finally, we argue that media and pharmacies may have an effect on the scientific-like perception of CAM therapies, contributing to the social construction of trust in its effectiveness. Therefore, widespread confusion about the scientific validation of homeopathy may be among the main factors driving its successful extension as a practice.

Use of Complementary and Alternative Medicine in Children With Tourette Syndrome.

Tourette syndrome is a neuropsychiatric condition defined by motor and phonic tics with onset in childhood. Many families have concerns regarding potential side effects of pharmacologic treatments, and often have difficulty accessing comprehensive behavioral intervention for tics. Patients and caregivers may turn to complementary and alternative medicine (CAM) as they perceive these as "natural" and therefore "safe." Although there are anecdotal reports of an increased use of CAM in Tourette syndrome patients, the exact prevalence is unknown. The purpose of this study was to identify commonly used CAM therapies for children with Tourette syndrome at Penn State Hershey Medical Center. A questionnaire was administered to the caregivers of children (<18 years old) via telephone. The data pertaining to demographics, type of CAM use, duration of use, adverse effects, and caregiver's perception of the effectiveness were collected. A total of 110 patients participated in this survey. When inquired about the different CAM methods, 69.1% of the participants reported using 1 or more CAM therapies, and 58% of those who used CAM informed the doctor about their use. Ninety-three percent of those who used CAM therapy reported a decrease in tic frequency. The most commonly used CAM therapies were stress management (44.6%), herbal medicine (18.2%), homeopathy (12.7%), and meditation (9.1%). In total, 46% of the participants said that CAM helped more than medication. The majority of patients interviewed were using CAM therapies, and a significant portion reported benefit greater than medication. More than half of all participants discussed CAM therapies with their physicians, and 63% of participants felt that their physicians would support their use of CAM therapies.

Quality of complementary and alternative medicine recommendations in low back pain guidelines: a systematic review.

Individuals with low back pain (LBP) often turn to complementary and alternative medicine (CAM) to seek relief. The purpose of this study was to determine mention of CAM in LBP clinical practice guidelines and assess the quality of CAM recommendations using the Appraisal of Guidelines, Research and Evaluation II (AGREE II) instrument. A systematic review was conducted to identify LBP guidelines. MEDLINE, EMBASE and CINAHL were searched from 2008 to 2018. The Guidelines International Network and the National Center for Complementary and Integrative Health websites were also searched. Eligible guidelines providing CAM recommendations were assessed with the AGREE II instrument. From 181 unique search results, 22 guidelines on the treatment and/or management of LBP were found, and 17 made recommendations on CAM therapy. With regard to scaled domain percentages, this overall guideline scored higher than the CAM section for 4 of 6 domains (overall, CAM): (1) scope and purpose (88.6%, 87.1%), (2) clarity of presentation (83.0%, 73.2%), (3) stakeholder involvement (57.0%, 41.7%), (4) rigor of development (47.2%, 44.7%), (5) editorial independence (34.8%, 34.8%) and (6) applicability (31.8%, 21.8%). The majority of LBP guidelines made CAM recommendations. The quality of CAM recommendations is significantly lower than overall recommendations across all domains with the exception of scope and purpose and editorial independence. This difference highlights the need for CAM recommendation quality improvement. Future research should identify CAM therapies which are supported by sufficient evidence to serve as the basis for guideline development. These slides can be retrieved under Electronic Supplementary Material.

Prevalence of complementary and alternative medicine (CAM) use in Brazil

BackgroundThe use of medicinal plants or other alternative practices can be the only therapeutic resources for many communities and ethnic groups, especially in developing countries. In Brazil, the Ministry of Health incorporated Complementary and Alternative Medicine (CAM) as a public health policy since 2006. The aim of this study was to evaluate the prevalence of CAM use in Brazil.MethodsThis was a cross-sectional study performed as an epidemiological survey, with data from the National Health Survey, 2013 that evaluated a sample of adult Brazilians (18+ years old). The outcome was the use of CAM therapies, such as acupuncture, homeopathy, medicinal plants and herbal medicines in the last 12 months. We employed a logistic regression model (CI 95%) to evaluate the chances of CAM use.ResultsThe prevalence of CAM use in Brazil was 4.5%. The subjects with higher chances to use CAM were: women (AOR = 1.42), aged > 40 years (AOR = 1.64), with higher educational levels (AOR = 2.35), and residents at North (AOR = 2.02) and South (AOR = 1.67) regions of Brazil, all with p-value < 0.001. According to the socioeconomic status, subjects from upper classes had higher chances to use acupuncture and homeopathy when compared to the other classes, and individuals from lower classes had higher chances to use medicinal plants and herbal medicines. Almost half of all individuals reporting CAM use did so outside the health care system. The Brazilian Unified Health System (SUS) was the least used funding for CAM when compared to other types of funding.ConclusionsWe recommend that the Ministry of Health invests in capacity building for health professionals who work with CAM, providing structure for those practices in health services, increasing the access of CAM therapies for SUS users, and improving the registering of information about those therapies, encouraging the use of CAM by the Brazilian population.

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

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

Searching for a ‘new magical world’: the contradictions of CAM and new age therapies in the West

Complementary and alternative medicines (CAM) and New Age therapies (NAt) are increasingly widespread in the West. Although the variety of therapies they recommend is very extensive, as is the variety of beliefs and practices, there are common ideas shared across both such as the concept of holism and the notion of energy. The case studies examined in this paper, Vittorio and Sol, both suffered from severe personal problems that caused a state of general malaise. They managed to address them through the holistic world. Through their experiences, it is possible to highlight the contradictions of CAM-NAt in the West. While, on one hand, these represent a form of resistance to capitalist culture, on the other there is a risk that CAM-NAt could end up reinforcing capitalistic logic through the establishment of an ‘individualistic holism’. The only solution to this situation seems to be a focus on the exercise of personal critical faculties, and an openness to different ways of conceiving the body, the health and diseases, but without, however, being drawn into the moralistic and individualist view that sometimes accompanies these.

Lifetime use of complementary and alternative medicine therapies among community-dwelling older people in Japan.

[Purpose] Three complementary and alternative medicine (CAM) therapies: “Judo therapy”, “acupuncture and moxibustion”, and “Japanese traditional massage and finger pressure” have been partially covered by the national health insurance in Japan. The lifetime prevalence of the use of these CAM therapies is not well known. The aim of the present study was to report the prevalence of the lifetime use of these CAM therapies. [Participants and Methods] We conducted a mailed self-administered questionnaire survey among community-dwelling older people in Japan in 2015. They were asked whether they had undergone any treatments with the 3 CAM therapies. The answers obtained were classified into 3 categories: current, ever, or never. We defined lifetime prevalence as the proportion of individuals who are currently using or have ever used any of these 3 therapies in the population. [Results] Overall, we approached 1051 individuals and 983 agreed to participate. Lifetime prevalence of Judo therapy, acupuncture and moxibustion, and Japanese traditional massage and finger pressure use was 28.0%, 17.8% and 15.8%, respectively, among males, and 44.5%, 18.4%, and 27.3%, respectively, among females. [Conclusion] These results showed that not only Western medicine but also CAM therapies are common among older people in Japan.

The use of complementary and alternative medicine by patients suffering from psoriasis and psoriatic arthritis

IntroductionPsoriasis is a chronic inflammatory disease, affecting 1–3% of the general population. In recent years there has been an increase in the use of complementary and alternative medicine (CAM) by psoriasis patients.AimTo assess the frequency of use of CAM by psoriasis patients, depending on selected demographic and clinical factors, and to examine such aspects as sources of knowledge about CAM therapies provided by patients, reasons for their use, and subjective patient satisfaction.Material and methodsThe study involved 117 psoriatic patients (female = 44, male = 73), hospitalised in the Dermatology Department of the Heliodor Swiecicki Clinical Hospital in Poznan. The research tool was the author's questionnaire, consisting of single- and multiple-choice questions about the use of CAM.Results57.26% of the respondents declared that they used or had used CAM for psoriasis. The analysis showed that the patients with psoriasis diagnosed in childhood statistically significantly more often used CAM compared to other patients (p = 0.017). The most frequent CAM therapies used by the responders were the use of topical agents (73.13%) and dietary supplements (71.64%). The main reason why psoriasis patients decided to use CAM was curiosity (34.33%), and the most commonly reported source of knowledge about CAM was the Internet (49.25%). The majority of responders monthly expenditure on CAM averaged less than PLN 100 (58.2%), and they were very dissatisfied with the effects of CAM (56.7%).ConclusionsPsoriasis patients use complementary and alternative medicine quite frequently. Dermatologists should keep this fact in mind and should ask about the use of CAM in interviews.

Knowledge on nurse led cam therapy among women with Gynaecological cancer

- CAM, as defined by the National Centre for Complementary and Alternative Medicine (CAM), is a diverse group of medical and health-care systems, practices, and products that may not yet be incorporated into conventional medicine. Aim: To assess the knowledge on Nurse led CAM therapy. Setting and Design: The study was conducted at NMCH, Nellore, by using a descriptive research design. Materials and Methods: 60 women were selected by purposive sampling technique. Structured questionnaire was used to collect the data and the collected data was organized, tabulated, analysed and interpreted by using Descriptive statistics and inferential statistics. Results: The study concluded that 30 (50%) participants had only 70% of knowledge on CAM. This concept helped to determine which options have efficacy and which do not.

The prevalence and determinants of complementary medicine use for nigerian children in the Turkish Republic of Northern Cyprus.

Complementary and alternative medicine (CAM) is extensively used in the pediatric population. Environments and the nature of diseases have an impact on the type of CAM therapies used in children. This study aims to determine the prevalence and determinants of CAM use among Nigerian children living in the Turkish Republic of Northern Cyprus (TRNC). A quantitative, descriptive and cross-sectional study was conducted among 50 parents living in the TRNC. The parents were selected by the snowball sampling technique. Data were collected using a self-administered, NAFKAM International-CAM-Questionnaire (I-CAM-Q). The data were analyzed using SPSS version 20. Chi-square test was used to analyze the associations of CAM use with values of P < 0.05 considered statistically significant. The mean ages of the parents and children were 30 ± 5.56 years and 3 ± 2.17 years, respectively. It was discovered that 34 (68%) out of 50 children had used CAM in the previous 12 months. The most commonly used CAM products were vitamins/minerals (82.4%) and herbs/herbal products (55.9%). While praying for health (61.8%) and relaxation techniques (50.0%) were the most used CAM practices. A majority of the parents perceived that CAM use was beneficial (85.3%). Approximately 10% of the children were prescribed CAM recommendation/treatment by physicians. The most used sources of information were relatives (36%) and friends (14.7%). Parents (58%) indicated that they did not disclose their use of CAMs for their children to a physician/nurse. CAM is used prevalently in this population and the use of CAM is primarily focused on improving well-being. CAM usage for children increases with parental use. Further qualitative research is needed to understand the parental belief in the use of CAMs for children.

Utilization of Complementary Alternative Medicine, Diet, and Exercise Among Women at High Risk for Developing Breast Cancer.

Background: Women diagnosed as having a high risk for breast cancer (HR-BC) often seek different health behaviors (HBs) such as complementary and alternative medicine (CAM), diet, and exercise to improve their health and cancer outcome. Methods: Women already enrolled in a multimodality screening study for patients at HR-BC (gene mutation carrier or >20% cumulative lifetime risk) were given a questionnaire to evaluate their use of CAM therapies, diet, and exercise before and after a diagnosis of HR-BC. Patients were also asked to complete the Short-Form 36, State-Trait Anxiety Inventory, and Beck Depression Inventory. Results: A total of 134 (67%) subjects completed the survey from the original cohort. General characteristics included a median age of 46 years (range = 24-73 years), majority were White (91%), BRCA1/2 gene mutation carrier (49%), and prior diagnosis of breast and/or ovarian cancer (30%). Almost all of the patients reported a lifetime prevalence of any HB (97%) and CAM utilization (91%). Subjects also had a high lifetime utilization of exercise (83%), herbs and supplements(72%), and diet programs (58%). All of these HBs declined in utilization after diagnosis of HR-BC by as much as 30%. After diagnosis of a HR-BC, a personal history of breast and/or ovarian cancer was significantly correlated with increased use of CAM (odds ratio [OR] = 5.9, P < .01), herbs and supplements (OR = 4.3, P < .01), and diet program (OR = 4.4, P < .01) in multivariate analysis. Conclusions: HBs such as CAM, diet, and exercise are highly prevalent among women with HR-BC, and the utilization of HB decreases significantly after diagnosis of HR-BC.

Combination of Rehabilitative Therapy with Ultramicronized Palmitoylethanolamide for Chronic Low Back Pain: An Observational Study.

IntroductionChronic low back pain (LBP) caused by intervertebral disc herniation was reported in the 2010 Global Burden of Disease study to be the main reason for years lived with disability. It causes significant personal, social, and economic burdens. Many of those who suffer from LBP find conventional medical treatments to be unsatisfactory for treating their pain, so they are increasingly resorting to complementary and alternative medicine (CAM) therapies. Given that the population is aging, there is an urgent need to characterize the combinations of complementary therapies that yield the best outcomes and treatments, even for prolonged periods. This observational study aimed to evaluate the effect of ultramicronized palmitoylethanolamide (umPEA) + CAM (daily functional rehabilitation + decontracting massage) therapies on chronic pain in patients suffering from multiple herniated discs in the lumbar spine.MethodsEligible patients received 600 mg of umPEA twice a day in combination with a daily functional rehabilitation session according to the McKenzie Method of Mechanical Diagnosis and Therapy plus a decontracting massage for 20 consecutive days, followed by 600 mg of umPEA once a day for 40 days in addition to standard therapy.ResultsThe results showed that the average pain intensity score, evaluated via the Numeric Rating Scale, progressively decreased during the study period, reaching a value that was not clinically relevant at the end of the observation period. Pain relief was paralleled by improvements in the physical and mental components of quality of life as evaluated with the SF-36 questionnaire as well as in disability for low back pain as evaluated with the Oswestry Disability Questionnaire. Collectively, the results demonstrate that umPEA in combination with CAM therapies could be an important strategy for combating LBP.ConclusionsThe multiple action of PEA in combination with CAM therapies may represent the multitarget approach needed to tackle the as-yet unsolved problem of chronic pain resistant to conventional therapies.

Use of complementary and alternative medicine in patients with inborn errors of metabolism: A single-center study.

Background and ObjectivesThere is a paucity of information on the use of complementary and alternative medicine (CAM) in patients with inborn errors of metabolism (IEM). This study's objective was to evaluate the self‐reported use and perceived effectiveness of CAM in adults and children with IEM.MethodsPatients aged 0‐70 years and caregivers seen at the London Health Sciences Centre Metabolic Clinic (London, Ontario, Canada) between July 2017 and August 2017 were recruited to complete a questionnaire regarding CAM use to help their IEM diagnosis and perceived effectiveness of these therapies. Survey responses were analyzed using descriptive statistics; age, sex, and education level associations among CAM users were tested using the Pearson χ 2 test.ResultsOf 50 potential participants, 44 (88%) completed the questionnaire, including 21 adults (6 by caregivers) and 23 children (22 by caregivers). The most common IEM category was Aminoacidopathies and Small Molecule Disorders (50%). Twenty‐seven (61%) participants reported CAM use to help their IEM diagnosis. The most common CAM therapies used were chiropractic manipulation, omega‐3 fatty acids, probiotics, and aromatherapy/essential oils. Most CAM users and caregivers (74%) perceived their CAM therapies as effective overall. Among CAM users, 40% had not discussed CAM use with a health care professional (HCP). CAM use was similar when comparing age, sex and education level.ConclusionsCAM is commonly used among patients with IEM. The safety and efficacy of CAM therapies for IEM should be further investigated. HCPs and patients should openly discuss CAM use in order to evaluate safety.