Conclusion Complementary And Alternative Medicine Research Articles

The Prevalence and Pattern of Using Complementary and Alternative Medicine in Saudi Patients With Diabetes: A Cross-Sectional Study.

Background Diabetes mellitus is a common disease in Saudi Arabia. Patients with chronic diseases, such as diabetes, tend to use complementary and alternative medicine (CAM) either as an addition or alternative to their medical therapy. Many studies have evaluated the CAM herbal products used by patients with diabetes; however, there have been few and inconsistent studies on other types of CAM, and most studies on CAM have focused on their use in type 2 diabetes. Objective This study aimed to determine the prevalence and patterns of CAM use among patients with type 1 or type 2 diabetes in Riyadh, Kingdom of Saudi Arabia. Methods This cross-sectional study was conducted in an adult Saudi population at King Abdulaziz Medical City, Riyadh, Kingdom of Saudi Arabia. Data were collected from December 2019 to February 2020 using a data collection form and patient interviews. Results We included 332 patients, 43% of whom had type 1 diabetes; 26% of the patients had previously used one or more types of CAM. Approximately 53% of CAM users had glycated hemoglobin (HbA1c) level of ≥9%. Among CAM users, 51% mentioned that their blood sugar readings were improved with CAM treatments. Mind-body therapy was the most commonly used CAM (54%), followed by biologically based CAM, including herbs (46%). The most commonly used herbal supplements were black cumin (42%), followed by fenugreek (28%), myrrh (24%), frankincense (22%), cinnamon (15%), garlic (15%), and onion (15%). Older age and employment status were predictors of CAM use in Saudi patients with diabetes. The main sources of knowledge about CAM were from family and friends. Conclusions CAM use is common among Saudi Arabian patients with diabetes. Patients with diabetes who are aged >65 years and employment status were the main predictor of CAM use. Assessing CAM use is an important aspect of clinical encounters with Saudi patients, especially patients with type 1 diabetes.

Knowledge, Attitude, and Use of Complementary and Alternative Medicine among Final-Year Pharmacy and Medical Students in Benghazi, Libya

Abstract Introduction Complementary and alternative medicine (CAM) is a growing branch of medicine that can improve the quality of life of many people. This study aimed to assess comparatively the knowledge, attitude, and use of CAM among graduation year pharmacy and medicine students at the University of Benghazi, Libya. Method A cross-sectional survey was conducted among graduation year pharmacy and medicine students at the University of Benghazi for 4 months. The study tool was a self-administered online questionnaire and consisted of four main sections: demographic data, use, knowledge, and attitude toward CAM. Results Most of the study respondents were females, and most were from Benghazi city. CAM use among pharmacy students was significantly higher (p-value= 0.001), with ruguia being the most commonly used modality (52.5%), followed by cupping-Al hijama and herbal medicine. Minor ailments and acute illnesses were the main medical conditions treated with CAM, and the unnecessary physician intervention was the top reason for practicing CAM among students. CAM knowledge and attitude were significantly higher among pharmacy students (p-value= 0.000 and 0.001, respectively). Conclusion CAM was commonly practiced among the study participants. Their overall knowledge of CAM was limited, whereas their attitude toward it was positive, with pharmacy students having a better degree of both.

Complementary and Alternative Medicine for the Treatment of Abnormal Endometrial Conditions in Women with PCOS: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Background Endometrial lesions in patients with polycystic ovary syndrome (PCOS) exhibit complex pathological features, and these patients are at risk of both short-term and long-term complications. Complementary and alternative medicine (CAM), which is gradually becoming more accepted and is believed to be clinically effective, claims to be promising for treating PCOS, and thus its effect on the abnormal endometrium of PCOS patients should be assessed. The present meta-analysis sought to evaluate the efficacy and safety of CAM in treating endometrial lesions in patients with PCOS. Methods Randomized trials on CAM were identified in four Chinese and seven English-language databases from their establishment to January 2020. The present study included patients diagnosed with PCOS and abnormal endometrial conditions who underwent CAM therapy independently or in combination with traditional western medicine. Data were extracted, and the Cochrane “risk of bias” tool was used to assess methodological quality. Effects were expressed as the relative risk (RR) or mean difference (MD/SMD) with 95% confidence interval (CI) as calculated with Rev Man 5.3. Results A total of 13 randomized controlled trials were included, involving 1,297 PCOS patients treated for endometrial abnormalities. Methodological quality was generally unclear or had a low risk of bias. The trials tested four different types of CAM therapies (i.e., traditional Chinese medicine treatment, acupuncture treatment, traditional Chinese medicine in combination with western medicine treatment, and acupuncture in combination with western medicine treatment). CAM treatment could significantly reduce the endometrial thickness in PCOS patients compared to western medicine alone (SMD −0.88, 95% CI [−0.12, −0.57]; I2 = 64%). Compared with clomiphene treatment for the induction of ovulation, CAM treatment showed a clear improvement in endometrial thickness during ovulation (SMD 2.03, 95% CI [1.64, 2.02]; I2 = 48%). Moreover, CAM was more effective than western medicine alone in reducing the endometrial spiral artery pulsatility index. No significant difference was seen between CAM and traditional treatment when these were used to improve traditional Chinese medicine syndrome scores. Acupuncture alone or traditional Chinese medicines (taken orally) in combination with western medicine significantly increased the pregnancy rate of PCOS patients (RR 1.59, 95% CI [1.30, 1.93]; I2 = 51%, P < 0.00001), and CAM was more effective than western medicine alone for improving hormone levels. No serious adverse events were reported in 11 of the 13 trials. Conclusions CAM may effectively ameliorate the endometrial condition of PCOS patients, and it can regulate the level of hormone secretion to increase the ovulation rate and the pregnancy rate.

Patterns of Complementary and Alternative Medicine Use in Saudi Arabian Patients With Inflammatory Bowel Disease: A Cross-Sectional Study.

BackgroundInflammatory bowel disease (IBD) concerns a group of chronic autoimmune diseases that results in uncontrolled inflammation of the gastrointestinal (GI) tract, which can lead to long-term complications. Conventional treatments for IBD usually target inflammation and include biologics and immunosuppressants, which have been associated with significant adverse effects. Also, non-response to biologics has been reported in up to 50% of patients. Hence, patients sometimes turn to unconventional methods of treatment, such as complementary and alternative medicine (CAM). In this study, we examine patterns of CAM use in Saudi patients diagnosed with IBD.Materials and methodsWe conducted a cross-sectional study of patients with IBD who were seen at the outpatient gastroenterology clinic between January 2018 and December 2019. Adult patients diagnosed with ulcerative colitis (UC) or Crohn’s disease (CD) were identified and surveyed. Clinical, laboratory, endoscopic, radiologic, and histologic data were collected. The patients completed a detailed questionnaire focusing on CAM use. Descriptive statics, quantitative variables, means, standard deviations (SDs), and minimum and maximum values or medians with interquartile ranges were used where appropriate; for qualitative variables, we reported frequencies. The prevalence of CAM use was calculated using standard prevalence formulae. Logistic regression analysis was performed to identify predictors for CAM use. A p-value of <0.05 was set as statistically significant.ResultsA total of 71 IBD patients were surveyed, of which 75% had CD. Severe symptoms were reported by 54% of patients, and 41% were receiving biological treatment; 90% of this cohort reported using some form of CAM, of which 78% used them within the past year, and 52% reported CAM treatment having a positive effect. Of note, 63% of patients reported using CAM therapy without the knowledge of their treating physician. The most common source of advice regarding the use of CAM medicine was relatives (66%), and the most common forms of CAM used were honey (62%), Zamzam water (54%), and physical activity (32%). Binary logistic regression analysis identified watery diarrhea (OR=5.7, 95% CI=1.0-31, P=0.04) and azathioprine (OR=18.1, 95% CI=1.3-255, P=0.03) as predictors of CAM use.ConclusionsCAM use is very common in Saudi patients with IBD. The majority of patients seem to turn to CAM if their symptoms are severe. They generally appear to be influenced by culture, the Internet, local society, and family tradition in their decision to use CAM, rather than expert advice from their treating physician.

Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain

Although complementary and alternative medicine (CAM) has been associated with reduced morbidity among adults with chronic back pain, less is known about the association between CAM use and health care expenditures. The objective of this study was to first estimate health care expenditures of adult CAM users and nonusers with chronic back pain and then assess CAM's influence on health care expenditures. This was an ambidirectional cohort study. Linked National Health Interview Survey (2012) and Medical Expenditure Panel Survey (2013-2014). CAM use was defined as 3 or more visits to a practitioner in the 12 months before the National Health Interview Survey interview. Covariates included age, sex, race-ethnicity, and body mass index. The outcome was annual health care expenditures (overall and within 8 categories, including office-based visits and prescription medication). Survey-weighted, covariate adjusted predicted marginal means models were applied to quantify health care expenditures. Survey-weighted, covariate adjusted linear and logistic regression models were used to investigate CAM's influence on expenditures, and the Z mediation test statistic was applied to quantify the independent effects of CAM. Overall, health care expenditures were significantly lower among CAM users with chronic back pain compared with non-CAM users for both 2013 and 2014: $8402 versus $9851 for 2013; $7748 versus $10,227 in 2014, annual differences of -$1499 (95% confidence interval: -$1701 to -$1197) and -$2479 (95% confidence interval: -$2696 to -$2262), respectively (P<0.001). Adult CAM users also had significantly lower prescription medication as well as outpatient expenses (P<0.001). CAM use was identified as a partial mediator to health care expenditures. CAM use is associated with lower overall health care expenditures, driven primarily by lower prescription and outpatient expenditures, among adults with chronic back pain in the United States.

The Use of Complementary and Alternative Medicine Is Less Frequent in Patients with Inflammatory Bowel Disease Than in Patients with Other Chronic Gastrointestinal Disorders.

Background and Aims Complementary and alternative medicine (CAM) is commonly used among patients with inflammatory bowel diseases (IBD), but evidence about its real-life use is limited. We aimed to assess and compare CAM use in outpatients with IBD and other gastrointestinal diseases. Materials and Methods The use of herbs and botanicals, lifestyle modifications and mind/body therapies, patient satisfaction, and continuous use of conventional medicine were assessed with an anonymous questionnaire at a tertiary IBD unit in Hungary. 396 IBD patients (207 with Crohn's disease, 185 with ulcerative colitis, and 4 with indeterminate colitis) and 164 patients with gastric acid-related diseases, premalignant and malignant colorectal diseases, lactose intolerance, celiac disease, dysbacteriosis, and so on were included. Results IBD patients reported significantly lower usage of herbs than did controls (25% versus 42%, p < 0.001). More than 90% of responding IBD patients continued conventional medication besides herbal remedies (83% in unaltered doses). IBD patients were more likely to implement lifestyle modifications (77% versus 63%, p = 0.0011), but not body/mind therapies (20% versus 15%, p = 0.1516). Younger age was a significant predictor of lifestyle modifications (p = 0.0246). Conclusions CAM use (especially that of herbal remedies) in IBD is less frequent than that in other gastrointestinal diseases. It is more a complementary than an alternative to conventional medicine in IBD. There is no significant difference between CAM use in patients with Crohn's disease and that in patients with ulcerative colitis, although the latter tend to choose herbs; the benefit of which is supported by scientific evidence. This study is registered at the Medical Research Council, Hungary. This trial is registered with 3769/2010/1018EKU.

Complementary and alternative healthcare use by participants in the PACE trial of treatments for chronic fatigue syndrome

Abstract Background Chronic Fatigue Syndrome (CFS) is characterised by persistent fatigue, disability and a range of other symptoms. The PACE trial was randomised to compare four non-pharmacological treatments for patients with CFS in secondary care clinics. The aims of this sub study were to describe the use of complementary and alternative medicine (CAM) in the trial sample and to test whether CAM use correlated with an improved outcome. Method CAM use was recorded at baseline and 52 weeks. Logistic and multiple regression models explored relationships between CAM use and both patient characteristics and trial outcomes. Results At baseline, 450/640 (70%) of participants used any sort of CAM; 199/640 (31%) participants were seeing a CAM practitioner and 410/640 (64%) were taking a CAM medication. At 52 weeks, those using any CAM fell to 379/589 (64%). Independent predictors of CAM use at baseline were female gender, local ME group membership, prior duration of CFS and treatment preference. At 52 weeks, the associated variables were being female, local ME group membership, and not being randomised to the preferred trial arm. There were no significant associations between any CAM use and fatigue at either baseline or 52 weeks. CAM use at baseline was associated with a mean (CI) difference of 4.10 (1.28, 6.91; p = 0.024) increased SF36 physical function score at 52 weeks, which did not reach the threshold for a clinically important difference. Conclusion CAM use is common in patients with CFS. It was not associated with any clinically important trial outcomes.

CAM use in pediatric neurology: an exploration of concurrent use with conventional medicine.

BackgroundPrevious studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM).ObjectiveTo assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada.MethodsA survey instrument was developed to inquire about use of CAM products and therapies, including reasons for use, perceived helpfulness, and concurrent use with conventional medicine, and administered to patients or their parents/guardians at the Stollery Children's Hospital in Edmonton and the Children's Hospital of Eastern Ontario (CHEO) in Ottawa.ResultsOverall CAM use at the Stollery was 78%, compared to 48% at CHEO. The most common CAM products used were multi-vitamins (84%), vitamin C (37%), homeopathic remedies (24%), and fish oil/omega 3 s (22%). The most common CAM practices used were massage (47%), chiropractic (37%), faith healing (18%), aromatherapy (16%), homeopathy (16%), and relaxation (16%). Many patients used CAM products at the same time as conventional medicine but just over half (57%) discussed this concurrent use with their physician.ConclusionCAM use is common in pediatric neurology patients and most respondents felt that it was helpful, with few or no harms associated. However, this use is often undisclosed, increasing possibility of interactions with conventional drugs. We urge clinicians to inquire about CAM use during routine history taking at every patient visit. Parents would clearly like more information about CAM from their specialty clinics; such information would be easier to share if more primary data were available about the safety and effectiveness of commonly used therapies.

Acupuncture-Based Modalities: Novel Alternative Approaches in the Treatment of Gastrointestinal Dysmotility in Patients with Systemic Sclerosis

The gastrointestinal (GI) dysmotility of systemic sclerosis (SSc, scleroderma) patients requires careful evaluation and intervention. The lack of effective prokinetic drugs motivate researchers to search for alternative treatments. We present an overview of the pathophysiology of SSc GI dysmotility and the advances in its management, with particular focus on acupuncture-related modalities and innovative therapies. Original research articles were identified based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline methodology. We have searched the MEDLINE database using Medical Subject Heading (MeSH) for all English and non-English articles with an English abstract from 2005 to October 2012. Only four original articles of various study designs were found studying Complementary and Alternative Medicine (CAM) therapies for SSc patients. Despite the small patient study numbers, CAM treatments, acupressure, and transcutaneous electroacupuncture, showed self-reported and physiologic evidence of improvement of GI functioning and/or symptoms in SSc patients. CAM therapies include experimental modalities with the potential to offer relief of symptoms from GI dysmotility. Larger studies are needed to investigate their optimal use in patient subsets to tailor therapies to patient needs.

지역사회 기반 소아 청소년 알레르기 환자의 보완대체요법 이용 실태조사

Objectives The purpose of this study is to see the prevalence and the patterns of the use of complementary and alternative medicine (CAM) in children and adolescent patients with allergies. Methods We analyzed data on 547 children and adolescents (age from 0-18 years old) chosen from all regions throughout the country with allergic diseases, including atopic dermatitis, allergic rhinitis, asthma and allergic urticaria. We used multiple logistic regression modeling to predict CAM use based on predictor variables. Results The previous 12-months prevalence of CAM usage in overall was 70.7% (atopic dermatitis, 78.1%; allergic rhinitis, 52.9%; asthma, 70.3%; allergic urticaria, 86.3%). Central and southern regions displayed significantly lower rate of using CAM compare to the northern region, and CAM was less likely to be used for the allergic rhinitis patients than the atopic dermatitis patients. The most commonly used CAM type was natural products (62.2%). Top five of the most frequently used CAM modalities were softener water, vitamin, red ginseng, wood bathing and aloe oil. One of the main reasons for trying CAM was from the `hope for a more effective outcomes in additional to the conventional medicine` (43.9%). The subjective effectiveness of CAM was found to be excellent in 74.0% of the patients, and 70.3% of the parents were willing to recommend CAM therapies to the others. Conclusions CAM is used widely to treat allergic diseases in children and adolescents in Korea. Korean medical doctors should actively discuss the use of CAM with the patients and provide information on the effectiveness and safety of CAM as guide in making choice for usage of CAM.

Complementary therapies for side effects of chemotherapy and radiotherapy in the upper gastrointestinal system

Introduction Chemotherapy and radiotherapy remain the mainstay of treatment for patients with advanced malignant disease that is incurable by local surgery. However, effective use of these therapies is limited by toxic effects. Serious side effects in the upper GI system include mucositis, xerostomia, nausea and vomiting. Standard care for these side effects is suboptimal. Recent studies suggest complementary and alternative medicine (CAM) may have a role in supportive care for people with cancer. We therefore reviewed the literature to assess the potential role of CAM in upper GI toxicities of chemo/radiotherapy. Methods We conducted a Medline term-combination search for articles in English that included: stomatitis, mucositis, xerostomia, nausea, vomiting, chemotherapy, radiotherapy, complimentary/alternative therapies, amino acids, antioxidants, vitamins, minerals, plant extracts, herbs, mind–body, guided imagery, hypnosis, acupuncture, massage and yoga. Results The initial search identified a total of 217 articles. Of these, 36 were selected and reviewed. Recommendations for integration of some CAM therapies in supportive cancer care can be made. Conclusion CAM therapies can be effective and safe in treating upper GI toxicities of chemo/radiotherapy. Guidelines in supportive cancer care should include appropriate CAM therapies, and patients need to be informed of such treatment options.

Frequency, type and factors associated with the use of complementary and alternative medicine in patients with Parkinson’s disease at a neurological outpatient clinic

Background Complementary and alternative medicine (CAM) is described as a set of healthcare and medical practices not currently part of conventional western medicine. In this study, we aimed to investigate the frequency, type and factors associated with the use of CAM in Parkinson’s disease (PD) patients at a neurological outpatient clinic. Method All PD patients at the outpatient clinic ( N = 421) received a postal questionnaire covering ten types of CAM plus an open alternative labelled ‘other type’, their possible effect, and socio-demographic, health and disease-related factors. Results 325/403 (81%) eligible patients responded comprising 172 men and 153 women, median age 74 years for both genders. CAM use was reported by (M/F) 51/59 patients (30/39%); 31/33 patients (18/22%) taking CAM drugs and 48/57 (28/37%) using CAM methods with acupuncture having the highest frequency. Significant differences between CAM users and non-users were found with regard to educational level, perceived health and levodopa load. More females than males used CAM, but the difference was not significant. The majority of CAM users perceived ‘No improvement‘ or ‘Some improvement’. Twenty percent of users reported that they had spent the equivalent of 50 € on CAM during the last 6 months. Conclusion CAM use is rather common among PD outpatients, with one in three having experience of CAM practices. Badly-perceived health and higher education were factors significantly associated with CAM utilization. A trend for more female CAM users was also seen.

Clinical indications and perceived effectiveness of complementary and alternative medicine in departments of obstetrics in Germany: A questionnaire study

Objective Our earlier study on complementary and alternative medicine (CAM) methods showed that acupuncture, homeopathy, and aromatherapy are available in most obstetrics departments in Germany but it did not evaluate the clinical indications for using CAM. The present study aimed to explore further the effectiveness of CAM use in obstetrics. Study design We sent all departments of obstetrics in North Rhine-Westphalia a questionnaire designed to delineate their use of acupuncture, homeopathy, and aromatherapy during childbirth. It sought details on who provided the CAM therapy (midwife or physician). We asked respondents to indicate on a five-point scale how reasonable or otherwise they would consider the provision of CAM in each of six common problem situations and to estimate for each the proportion of patients given the CAM treatment. Respondents were also asked about the rationale for offering CAM, quality assurance and side effects. Spearman's bivariate correlation, cross-tabulation and Pearson's χ 2 test were used for statistical analysis. Results About 73.4% (138/187) of the departments responded. Acupuncture and homoeopathy were most widely used. Although obstetricians are responsible for patient care, decisions to provide CAM were largely taken by midwives, and the midwives’ belief in the methods’ effectiveness and patient demand were the principle motivating factors. Rates of CAM use in the six problem scenarios evaluated were directly related to practitioners’ perceptions of the methods’ therapeutic effectiveness. Conclusions CAM methods were widely offered despite the lack of evidence of effectiveness or information on adverse consequences. In Germany, including CAM in the mandatory national quality assurance measures and perinatal surveys would provide valuable information; CAM use elsewhere merits further study.

Quality of life and complementary and alternative medicine use among cancer patients in Turkey

Aim The purpose of this study was to assess the relationships between quality of life and use of complementary and alternative medicine (CAM) among Turkish cancer patients. Methods This cross-sectional study was conducted in Istanbul University Institute of Oncology, Turkey. Two-hundred patients were invited and informed consent was obtained, however 179 cancer patients completed the study. The Patient Characteristics form, The Nightingale Symptom Assessment Scale and The Functional Assessment of Cancer Therapy Scale were used in the evaluation of the patients’ characteristics and quality of life. Results Some form of CAM had been used by 71.5% of the sample. Frequently used CAM methods appeared to be religious practices (68.2%) and only 37.4% of the patients used herbs. However, female patients, single patients, and individuals with metastatic disease and worse quality of life showed a tendency to use CAM more often. More than one-third of our patients began to use CAM immediately after being diagnosed with cancer and factors associated with CAM use varied according to the type of CAM. Although CAM use did not affect the patients’ quality of life, logistic regression analysis revealed that gender, type of cancer diagnosis and education level were important factors to be considered in different CAM therapies. Conclusion CAM use is common in cancer patients in Turkey. More discussion about CAM use should take place between patients and health professionals to inform the patients’ decisions.

Use of Complementary and Alternative Medicine by Patients Attending a Rhinology Outpatient Clinic

There are 50,000 practitioners of complementary and alternative medicine (CAM) within the United Kingdom. The current U.K. prevalence of CAM use is reported to be 25% and is rising. The national expenditure on CAM is an estimated pound1.6 billion. The aim of this study was to explore the pattern of CAM use in patients attending a rhinology outpatient clinic in Aberdeen. Questionnaires were provided to 100 patients over a 2-month period. The questionnaire consisted of demographic sections and whether they had ever used CAM from a list of 49 herbal and nonherbal alternative therapies. Subjects were also asked why they used CAM, where they learned of CAM, whether they found it efficacious, and whether their general practitioner was aware they were using it. One hundred subjects completed questionnaires. Patients attending the clinic were suffering from the most common rhinological complaints including rhinosinusitis and nasal polyps. Sixty-five percent of patients had ever used CAM. Women were statistically significantly more likely to use CAM than men (p = 0.012). Patients who were employed were more likely to use CAM, but there was no significant difference in CAM usage depending on marital status, social class, and age. Only 6% of patients felt CAM use was definitely ineffective. Only 43% of users of CAM had informed their doctor about its use. CAM usage is growing in popularity. All health care professionals should be aware of this and of the potential for adverse drug reactions occurring. The dangers of noncompliance with conventional medications should be emphasized to CAM users.

Use of complementary and alternative medicine in children with cancer in Occidental, Mexico

To describe the types of complementary and alternative medicine (CAM) used by pediatric cancer patients attending a tertiary care hospital in Western Mexico. In a cross-sectional survey, parents were interviewed and types of CAM employed as well as factors related to their use and their perceived effectiveness were determined. One hundred ten parents of pediatric cancer patients completed the survey. Seventy-seven patients (70%) received CAM. Of CAM used, herbal remedies (69%) and orally administered products (26%) were most common. Mean number of therapies was 2 +/- 1.1 (95% CI 1.59-2.12). Prior CAM use by the family was associated with use in patients (P = 0.006) (OR 4.6, CI 95% 1.7-12.9). Perceived usefulness was reported in 79% of CAM users. CAM use in Mexican children is common, most frequently with herbal therapies. The majority perceived benefits with its usage but in most cases, the treating physician was not informed about this practice.

Complementary and Alternative Medicine Use Among Mid-Life Women

Purpose Complementary and alternative medicine (CAM) has become widely used, with approximately 22% of all adults having used CAM in 2002. Many women are investigating alternatives to hormone therapy for menopausal symptoms, in part due to the recent results of the Women's Health Initiative. Physicians should ascertain CAM use in their patients to avoid possible interactions with prescribed drug. This study analyzes CAM use among menopausal women and CAM used specifically for menopausal symptoms. Methods Data were obtained from the 2002 National Health Interview Survey (NHIS). The sample was limited to women 45–57 years of age for whom menopausal symptom data were obtained (n = 3663). CAM use was analyzed by SUDAAN to account for the complex sampling design of the NHIS and weighted to obtain nationally representative estimates. Results More than 43% of women 45–57 used CAM in the previous year. Use increased with education, from 28% among women without a high school degree to 63% among women with a master's degree or higher. After controlling for age and race/ethnicity, women who reported menopausal symptoms were almost twice as likely to use CAM as those without symptoms (prevalence odds ratio = 1.8, 95% confidence interval (CI 95%) = 1.5,2.1). Forty six percent of women using CAM had informed a traditional health practitioner of this, which was not significantly associated with demographic or menopause characteristics. Only 3.3% of women 45–57 used CAM specifically for menopause (CI 95% = 2.7%–4.0%), with natural herbs the modality mentioned by 2.8%. Education was positively associated with CAM used specifically for menopausal symptoms. Conclusion CAM use among mid-life women is higher than use among all U.S. adults. Women experiencing menopausal symptoms are almost twice as likely to use CAM as other women at the same age, especially among more highly educated women. The use of CAM, however, is generally not related specifically to menopause. More physicians need to ask their patients about CAM use to obtain complete medical histories.

Complementary and Alternative Medicine Use by Patients Enrolled Onto Phase I Clinical Trials

To describe the prevalence, clinical characteristics, and pattern of use of complementary and alternative medicine (CAM) in patients enrolled onto phase I trials. Questionnaires were administered to 108 patients with advanced malignancies enrolled onto phase I chemotherapy trials at the Mayo Clinic Comprehensive Cancer Center (Rochester, MN). CAM was classified into two modalities, pharmacologic and nonpharmacologic. Clinical and demographic data, including age, sex, and prior cancer treatment, were subsequently obtained from patient charts and examined for any correlation with CAM use, using chi2 analysis. One hundred two survey forms were returned. Among respondents, 88.2% (90 of 102) had used at least one CAM modality; 93.3% (84 of 90) and 53.3% (48 of 90) had used pharmacologic and nonpharmacologic CAM, respectively; and 46.7% (42 of 90) used both modalities. Vitamin and mineral preparations constituted 89.3% (75 of 84) of all pharmacologic CAM used. Intake was highest for vitamins E (48.8% [41 of 84]) and C (38.1% [32 of 84]), and 71.4% (60 of 84) of respondents took nonvitamin/mineral agents. Green tea (29.8% [25 of 84]), echinacea (13.1% [11 of 84]), and essiac (9.5% [8 of 84]) were the most popular. Prayer and spiritual practices were the most commonly used nonpharmacologic CAM, accounting for 52.1% (25 of 48). Chiropractors, the most frequently visited nontraditional medicine practitioners, were consulted by only 10% (9 of 90) of those who practiced CAM. Both CAM modalities were used more frequently by women (53.5% [23 of 43]) than men (40.4% [19 of 47]). CAM use is common among patients in phase I trials and should be ascertained by investigators, because some of the agents used may interact with investigational agents and affect adverse effects and/or efficacy.