Current Complementary And Alternative Medicine Research Articles

Comparative efficacy of eight oral Chinese patent medicines for dilated cardiomyopathy with heart failure: a Bayesian network meta-analysis.

Chinese patent medicines (CPMs) are widely used in China as an adjuvant treatment in dilated cardiomyopathy with heart failure (DCM-HF). However, comprehensive and systematic evidence supporting the beneficial effects of CPMs combined with current complementary and alternative medicine (CAM) treatments against DCM-HF was limited. This network meta-analysis (NMA) aimed to assess and rank the relative efficacy of eight different CPMs for DCM-HF. To retrieve randomized controlled trials (RCTs) focusing on the use of CPMs combined with CAM for DCM-HF, the databases of PubMed, Embase, Web of Science Core Collection, Cochrane Library, ProQuest, China National Knowledge Infrastructure (CNKI), China Science Periodical Database (CSPD), Chinese Citation Database (CCD), Chinese Biomedical Literature Database (CBM), and ClinicalTrials.gov were comprehensively searched from their inception to 29 February 2024. The quality of the included RCTs was examined using the Cochrane Risk of Bias assessment tool, version 2.0 (RoB 2). Surface under the cumulative ranking curve (SUCRA) probability values were applied to rank the relative efficacy. Bayesian network meta-analysis was designed to assess the efficacy of different CPMs. After applying the inclusion and exclusion criteria, a total of 77 eligible RCTs involving 6980 patients were enrolled. The outcomes assessed included clinical effectiveness rate (CER), left ventricular ejection fraction (LVEF), left ventricular end-diastolic dimension (LVEDD), 6-min walk test (6MWT), brain natriuretic peptide (BNP), and cardiac output (CO). The results of the NMA indicated that Qili Qiangxin capsule (QLQX), Wenxin granule (WX), Tongxinluo capsule (TXL), Qishen Yiqi dropping pill (QSYQ), Shexiang Baoxin pill (SXBX), Yangxinshi tablet (YXST), Yixinshu capsule (YXSC), and Getong Tongluo capsule (GTTL) combined with CAM significantly improved performance compared with CAM alone in treating DCM-HF. YXST + CAM (MD = - 9.93, 95% CI - 12.83 to - 7.03) had the highest probability of being the best treatment on account of the enhancement of LVEF. WX + CAM had the highest likelihood of being the best treatment considering the improvement in LVEDD (MD = - 11.7, 95% CI - 15.70 to - 7.79) and 6MWT (MD = - 51.58, 95% CI - 73.40 to - 29.76). QLQX + CAM (MD = - 158.59, 95% CI - 267.70 to - 49.49) had the highest likelihood of being the best intervention for the reduction in BNP. TXL + CAM (MD = - 0.93, 95% CI - 1.46 to - 0.40) might be the optimal choice for increasing CO levels in DCM-HF patients. No serious treatment-emergent adverse events were observed. This NMA suggested that adding CPMs to the current CAM treatment exerted a more positive effect on DCM-HF. Thereinto, QLQX + CAM, TXL + CAM, WX + CAM, and YXST + CAM showed a preferable improvement in patients with DCM-HF when unified considering the clinical effectiveness rate and other outcomes. Furthermore, due to the lack of information on CPMs against DCM-HF and the uneven distribution of included studies among interventions, more high-quality studies are needed to provide more robust evidence to support our findings. PROSPERO (CRD42023482669).

Autism Spectrum Disorder: When There is no Cure, There are Countless of Treatments.

We investigated parent reports of use of special education and support services, use of evidence-based practices (EBPs), use of past and current complementary and alternative medicine (CAM) treatments, non-use of CAM treatments, willingness, and unwillingness to use CAM treatments, reasons for use and non-use of CAM treatments, and perceptions of EBPs and CAM treatments in their children's functioning. We collected data from a total of 166 parents of children with autism spectrum disorder (ASD) through a web-based survey. 94% of the parents reported lifetime use of at least one CAM treatment. Parents weighed on a wide variety of factors in decision-making. CAM treatments use was positively associated with parental educational level, length of time since ASD diagnosis, and child's ASD severity.

Complementary and alternative medicine use among cancer patients at two cancer centers in Brazil.

12060 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use among cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at two cancer centers in Brazil from January 2020 to January 2021. Unadjusted and adjusted analyses were conducted by using Logistic Regression models to determine the association of covariates with binary outcome. Statistical analyses were performed with SAS 9.4 (SAS Institute Inc, Cary, NC). All tests were 2-sided, and P < 0.05 was considered significant. Results: In total, 319 patients who consented to the face-to-face interview were included and all of them completed the questionnaires. Most patients (52.4%) were between 51 and 70 years-old, 59,6% were female, 85,2% were from the private service and 67% had college graduate/baccalaureate. Most cancer types were from gastrointestinal tract (31,4%), breast (20.4%), lung (12.3%) and genitourinary type. More than 85% of the participants were on any active cancer treatment. The prevalence of current CAM use was 34.2% and 50.2% of the patients did not believe CAM has anti-cancer properties. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 4.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,008) as well as a higher proportion of CAM use among private patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and private patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.

Use of complementary and alternative medicine in patients with ankylosing spondylitis.

Some studies have shown that the use of complementary and alternative medicine (CAM) is common in patients with chronic painful conditions, such as ankylosing spondylitis (AS). This study aimed to determine the prevalence and types of CAM usage in patients with AS and to evaluate the impact of treatment adherence and beliefs about medicines on CAM usage. This study has a descriptive design. A total of 140 patients with AS were included. The treatment adherence of the patients was evaluated using the Morisky Green Levine Medication Adherence Scale. The Beliefs about Medicines Questionnaire (BMQ-T) was used to assess patients' beliefs about medicines. Previous or current CAM usage was stated by 40% of the patients. It has been found that CAM usage was significantly high (p<0.05) in patients who were married, older, and diagnosed at older ages. The difference between patients' beliefs about medicines and CAM usage was not statistically significant (p>0.05). The BMQ-T scores were significantly different in terms of the patients' treatment adherence (p<0.05). This study showed that approximately half of the patients with AS were using 1 CAM method. Furthermore, medication adherence and patients' beliefs about medicines did not have any impact on CAM usage, but the patients' beliefs about medicines affected treatment adherence.

Use of complementary and alternative medicine (CAM) among emergency department (ED) patients in Sweden

BackgroundIt has been suggested that the combination of complementary and alternative medicine (CAM) with conventional medicine carries a risk of adverse effects. The prevalence of CAM usage among patients in the Swedish emergency department (ED) is unknown. Hence, the aim of this study was to investigate CAM use among visiting patients at a Swedish ED.MethodA cross-sectional descriptive study was performed between August and October 2016 at an ED in Sweden. The questionnaire included 16 items regarding CAM use, factors associated with CAM use and patient healthcare communication and was distributed to 1600 patients.ResultsA total of 1029 questionnaires was returned (RR 64.3%). Current CAM use was reported by 7.9%, during the last year by 38.0%, and within lifetime by 72.9%. Factors associated with CAM use were: being a woman, middle-aged, in full-time employment, with secondary education level, higher use of non-prescription drugs and lower use of prescription drugs. Patient healthcare personnel communication about CAM was found to be approximately 5%.ConclusionCAM usage exists among patients visiting Swedish EDs and almost one in ten uses CAM on the same day as the ED visit. CAM usage is associated with demographic factors. However, communication about CAM usage with ED personnel is poor.

Complementary and alternative medicine use among cancer patients at a private hospital in Brazil.

e14144 Background: Complementary and alternative medicine (CAM) use is relatively common among cancer patients. Data regarding CAM use in Brazil is scarce. We sought to define CAM use by cancer patients and investigate factors that might influence it. Methods: We conducted a cross-sectional survey of adults diagnosed with any cancer type who came to appointments at our outpatient clinic in January 2020. Chi-square tests were used to investigate the association between CAM use and age and gender Results: We interviewed 156 patients who consented to the face-to-face interview and all of them completed the questionnaires. Most patients were between 51 and 70 years-old; 56% were female and 55% had their cancer diagnosed in the last 12 months. Most cancer types were breast (17.4%), colorectal (16.7%), and lung (16.1%). More than 90% of the participants were on any active treatment. The prevalence of current CAM use was 29.6%. 58.7% of the patients did not believe CAM has anti-cancer properties, including 32.6% of patients who reported CAM use. Two-thirds of the participants have never discussed about CAM with their oncologists. Only 5.1% of the respondents would abandon conventional cancer treatment in order to use just CAM. Among CAM users, 55% referred multiple therapies use. Of those therapies, spiritual surgery was the most prevalent one. There was a significant higher proportion of females reporting CAM use (p = 0,029) as well as a higher proportion of CAM use among younger patients (p = 0,008). Conclusions: CAM use was common among our study population, especially spiritual surgery. Women and younger patients were more prone to use CAM. Although most patients would not abandon conventional treatment, many of them have never discussed about CAM with their oncologists.

Changes in prevalence and perception of complementary and alternative medicine use in Korean inflammatory bowel disease patients: results of an 8-year follow-up survey.

Background/AimsThe use of complementary and alternative medicine (CAM) is a global phenomenon, including inflammatory bowel disease (IBD) patients. We aimed to assess the change in prevalence and patterns of CAM use, and attitudes towards CAM over an 8-year time interval (2006 vs. 2014) among IBD patients in Korea.MethodsA total of 221 IBD patients (CD=142, UC=79) were asked to complete a questionnaire regarding CAM at two time points: at enrollment (2006) and 8 years later (2014/2015).ResultsThe proportion of patients ever using CAM increased significantly from 60.2% in 2006 to 79.6% in 2014 (P<0.001), while the proportion of current CAM users increased slightly (35.7% to 38.0%, P=0.635); 21.7% used CAM consistently at both time points. The proportion of patients who felt CAM was less effective (P<0.001) and more expensive (P=0.04) than conventional treatments increased over time. Also, the proportion among ever CAM users who perceived a positive effect from CAM significantly decreased in 2014 compared to 2006 (P=0.004). Higher education (adjusted odds ratio [aOR], 2.10), prior side effects to conventional therapies (aOR, 2.23), and prior use of corticosteroids (aOR, 2.51) were associated with CAM use. Interestingly, use of CAM before IBD diagnosis (aOR, 2.73) was significantly associated with consistent CAM use.ConclusionsAlthough the attitudes toward CAM have become less favorable, the majority of IBD patients have experienced CAM with an overall increase of current CAM users over time. Moreover, more than half of current CAM users used CAM consistently over time.

Complementary and Alternative Medicine Practice Among Saudi Patients with Chronic Kidney Disease: A Cross-Sectional Study.

ObjectiveComplementary and alternative medicine (CAM) practice in patients with chronic kidney disease (CKD) has significantly increased. However, statistics regarding CAM practices among patients with CKD in Saudi and worldwide are limited. Hence, this study aimed to explore the prevalence and types of CAM in Saudi patients with CKD.MethodsA cross-sectional study was conducted in 315 patients, who were divided into CKD stages 3–4, CKD stage 5-hemodialysis, and kidney transplant with functioning allografts, by using a convenience sampling technique between September and December 2018. Next, they answered a self-administered questionnaire. The study outcomes were the prevalence of CAM, CAM types, reasons for using herbs, and the source of information about CAM.ResultsOverall, 54.9% of the study participants were current CAM users, of which 88.4% were herbal consumers. Patients with CKD stages 3–4 accounted for 87.3% of the CAM users, followed by those with CKD 5-hemodialysis (7.5%) and CKD-transplant recipients (5.2%). CAM practice was associated with monthly income (P = 0.021). Meanwhile, 79% of CAM users did not report their CAM practices to their primary physicians. Nigella sativa and parsley were the most commonly consumed herbs by CAM users [94 (61.4%) and 78 (51%), respectively].ConclusionCAM practice and herb consumption were highly prevalent among patients with CKD. Patients inadequately inform the primary physicians about their CAM practices. Therefore, healthcare providers are encouraged to inquire about these practices.

Prevalence and indicators of use of complementary and alternative medicine in Austrian patients with inflammatory bowel disease.

Complementary and alternative medicine (CAM) seems to be frequently used among patients with inflammatory bowel disease (IBD). We aimed to determine the prevalence and indicators of CAM use in Austrian IBD patients. In a multicentre cross-sectional study, adult patients with IBD attending 18 Austrian outpatient clinics completed a multi-item questionnaire that recorded use of CAM as well as medical and socioeconomic characteristics. Patients were recruited between June 2014 and June 2015. The study outcome was the prevalence of CAM use and its socioeconomic and disease-related associations. A total of 1286 patients (Crohn's disease 830, ulcerative colitis 435, IBD unclassified 21; females 651) with a median age of 40 years (interquartile range 31-52 years) and a median disease duration of 10 years (4-18 years) were analysed. The prevalence of previous and/or current CAM use was 50.7%, with similar results for Crohn's disease and ulcerative colitis. In the multivariable analysis, female gender and a university education were independent socioeconomic indicators of CAM use. IBD-related indicators were longer duration of the disease and previous and/or current treatment with steroids and TNF-α inhibitors. CAM use for IBD is frequent in Austrian IBD patients and associated with female gender, higher educational level of university degree, longer duration of the disease, and treatment with steroids and TNF-α inhibitors.

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

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

Complementary medicine in radiation oncology

Recently, complementary and alternative medicine (CAM) has moved more into the focus, and cancer societies such as the German Cancer Society (Deutsche Krebsgesellschaft, DKG) have established working groups to develop aguideline for CAM. The present work aims to evaluate the acceptance of CAM in the whole radiation oncology community. We conducted an online survey on CAM and sent the modified questionnaire that was successfully distributed to all members of the Research Group on Gynecological Oncology (Arbeitsgemeinschaft Gynakologische Onkologie, AGO) of the DKG in 2014 to the members of the German Society of Radiation Oncology (Deutsche Gesellschaft für Radioonkologie und Strahlentherapie, DEGRO). The survey consisted of 17questions regarding personal information and current CAM guidelines within the workplace/clinic. Atotal of 143 members participated. Of these, 12% had some CAM qualification. For hematological cancer in 35% and in up to 76% for breast cancer, CAM treatment is offered in German radiation oncology facilities, mainly due to fatigue symptoms. CAM is part of routine treatment in 32.2%, 22.0% are planning to incorporate it. Most physicians advise patients to partake in sports activities and recommend dietary supplements and nutritional counseling. The cost of CAM treatment is fully covered in 9.8% of all participating facilities. Today, CAM is integrated into cancer care; however, skepticism regarding its effect still exists. Evidence-based results must be generated to convince physicians of the effectiveness of CAM methods. CAM qualifications must be included in physicians' training to improve their understanding and counseling regarding CAM options in cancer care.

The role of mind-body awareness in the outcomes of complementary and alternative medicine (CAM)

IntroductionMind-body awareness is often viewed as an outcome of using complementary and alternative medicine (CAM). Emerging evidence suggests that mind-body awareness may be an intermediate outcome that contributes to CAM-related outcomes. The current study aimed to test a model of mind-body awareness as an intermediate outcome of CAM use via provider autonomy support that facilitates quality of life and health behaviour changes. MethodsUndergraduate students (N = 243, M age = 23.5, 84% female) screened for current CAM use, completed an online survey including questions about their CAM use, perceived outcomes from use of CAM, a measure of CAM provider autonomy support, and a new 8-item measure of Mind-body Awareness (MBA). ResultsBivariate analyses confirmed that those with high MBA had higher scores on positive CAM-related health behaviour (diet, weight loss, exercise) and quality of life (sleep quality, mood, energy levels, concentration) changes. Path analysis controlling for demographics and health status tested the proposed model of CAM use predicting provider autonomy support, and in turn MBA and two CAM-related outcomes. The model fit well to the data, CFI = 0.94, TLI = 0.91, RMSEA = 0.03, supporting the hypotheses that CAM use is associated with higher MBA via increased autonomy support, and MBA contributes to quality of life and health behaviour changes. ConclusionsFindings extend previous research on mind-body awareness by linking it to CAM-related quality of life and behavioural outcomes in a sample of young adult CAM consumers, and further suggest a route through which provider support may enhance CAM outcomes.

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.

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

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

Use of complementary and alternative medicines is associated with delay to initiation of disease-modifying anti-rheumatic drug therapy in early inflammatory arthritis.

To study the predictors of complementary and alternative medicine (CAM) use in patients with early inflammatory arthritis (EIA), and its impact on delay to initiation of disease-modifying anti-rheumatic drugs (DMARD). Data were collected prospectively from EIA patients aged ≥ 21 years. Current or prior CAM use was ascertained by face-to-face interview. Predictors of CAM use and its effect on time to DMARD initiation were determined by multivariate logistic regression and Cox proportional hazards, respectively. One hundred and eighty patients (70.6% female, 58.3% Chinese), of median (interquartile range [IQR]) age 51.1 (40.9-59.8) years and symptom duration 16.6 (9.2-26.6) weeks were included: 83.9% had rheumatoid arthritis, 57% were seropositive. Median (IQR) Disease Activity Score in 28-joints (DAS28) was 4.3 (2.8-5.7), modified Health Assessment Questionnaire (mHAQ) was 0.38 (0.0-0.88) and 41.3% were CAM users. Chinese race (odds ratio [OR] 5.76 [95%CI 2.53-13.1]), being non-English speaking (OR 2.68 [95% CI 1.18-6.09]), smoking (OR 3.35 [95% CI 1.23-9.15] and high DAS28 (OR 2.73 [95% CI 1.05-7.09] were independent predictors of CAM use. CAM users initiated DMARD later (median [IQR] 21.5 [13.1-30.4] vs. 15.6 [9.4-22.7] weeks in non-users, P = 0.005). CAM use and higher DAS28 were associated with a longer delay to DMARD initiation (hazard ratio [HR] 0.69, 95% CI 0.50-0.95 and 0.63, 95% CI 0.43-0.91, respectively) while higher mHAQ was associated with a shorter delay (HR 1.59, 95% CI 1.08-2.34) and race, education level, being non-English speaking, smoking and seropositivity were not associated. Healthcare professionals should be aware of the unique challenges in treating patients with EIA in Asia. Healthcare beliefs regarding CAM may need to be addressed to reduce treatment delay.

Timeliness of Autism Spectrum Disorder Diagnosis and Use of Services Among U.S. Elementary School-Aged Children.

This study assessed the relationship of timeliness of autism spectrum disorder (ASD) diagnosis with current use of ASD-related services in a nationally representative sample of U.S. children. The Centers for Disease Control's (CDC's) Survey of Pathways to Diagnosis and Services was used to assess experiences of 722 children ages six to 11 with ASD. Bivariate and multivariate analyses were used to explore associations between age at ASD diagnosis and delay in ASD diagnosis and use of health services. Health services included current use of behavioral intervention (BI) therapy, school-based therapy, complementary and alternative medicine (CAM), and psychotropic medications. Mean age at ASD diagnosis was 4.4 years, and mean diagnostic delay was 2.2 years. In adjusted analysis, older age at diagnosis (≥4 versus <4) was associated with lower likelihood of current BI or school-based therapy use and higher likelihood of current psychotropic medication use. Analyses that treated age at diagnosis as a continuous variable found that likelihood of current psychotropic medication use increased with older age at diagnosis. A delay of two or more years between parents' first discussion of concerns with a provider and ASD diagnosis was associated with higher likelihood of current CAM use. Likelihood of current CAM use increased as delay in diagnosis became longer. Both older age at diagnosis and longer delay in diagnosis were associated with different health services utilization patterns among younger children with ASD. Prompt and early diagnosis may be associated with increased use of evidence-based therapies for ASD.

Does complementary and alternative medicine (CAM) use reduce negative life impact of headaches for chronic migraineurs? A national survey.

BackgroundChronic migraine is a disabling condition that impacts multiple aspects of migraineurs’ lives. Although pharmacological treatments can help to treat the pain associated with migraine headache, chronic migraineurs often experience side-effects of pharmacological treatments. Those experiences may contribute to the observed growth in complementary and alternative medicine (CAM) use among migraineurs. Relatively little is known about the patterns of CAM treatment and the characteristics of chronic migraineurs. Therefore, the purpose of the present study is to investigate the characteristics of chronic migraineurs who use CAM treatment and the relationship among satisfaction with current CAM use, negative life impact, migraine outcomes, and psychiatric comorbidities among chronic migraineurs.Methods2907 participants were recruited from a well-known online migraine headache resource. All participants were US adults aged 18 years or older. Migraineurs are referred to this website through various routes (e.g., referral from healthcare providers, internet search, obtaining information from research papers, personal invitation from other users, and information shared on social media etc.). Participants completed a 30-min self-report-survey in the spring of 2014.ResultsAlmost half of the participants reported that they are currently using more than three different CAM treatments even though the majority of the participants reported neutral or dissatisfied with their current CAM treatment. Chronic migraineurs who use CAM treatments were more likely to experience prolonged or frequent migraine headaches (p = .018, η2 = .0021), and experience greater negative life impact from their headaches (p = .000, η2 = .0172) compared to non-CAM users. CAM treatment satisfaction was inversely related to the number of psychiatric comorbidities, frequency of migraines, and number of migraine symptoms (p’s < .05). However, CAM treatment satisfaction was more strongly correlated with migraine outcomes than psychiatric comorbidities.ConclusionsChronic migraineurs often pursue multiple CAM treatments in spite of low levels of satisfaction with those treatments. Patients who experience relief from traditional treatments are less likely to seek the out additional CAM treatments. Thus it is often the sicker migraine patients who use CAM. More attention is needed to consider migraine treatment resistance, and psychological factors in planning the treatment of chronic migraineurs as those factors may play an important role in treatment choices by patients.

Self-Management of Arthritis Symptoms by Complementary and Alternative Medicine Movement Therapies.

This study describes the association between current use of different complementary and alternative medicine (CAM) movement therapies (MTs) and arthritis symptoms (pain, fatigue, difficulty with physical function, and feelings of helplessness). By using a cross-sectional design, 2140 participants with arthritis or chronic joint symptoms completed a survey about CAM use. Adjusted means for arthritis symptoms were reported by current use of CAM MTs and current use of yoga. Approximately 19% (n = 398) of the total respondents were "currently using" some form of MT. Of those reporting current use, 89.2% of the participants reported current use of yoga. After adjustment for a variety of characteristics, relative to participants who reported no current CAM MT use, participants with current use of CAM MT had significantly increased pain symptoms and a higher level of perceived helplessness. This descriptive study indicates that patients with arthritis or chronic joint symptoms selecting CAM MT for self-management may be doing so because of more symptom involvement, specifically more pain and feelings of helplessness. Because of its increasing use, yoga warrants special attention by practitioners as a nonpharmacologic self-management therapy for arthritis symptoms.

Critical reflections about current ‘CAM’ research and advocacy

Complementary and alternative medicine (CAM) is an area that has become tolerated or even accepted by most conventional health care professionals and favoured by many consumers. Yet, critical thinkers might find it hard not to note the many problems and contradictions in this field. This article is an attempt to explore some of the problems that exist in current CAM advocacy and research. For the most part, these reflections are based on the author's 20 years of experience as a CAM researcher rather than on citable evidence.

Prevalence and modes of complementary and alternative medicine use among peasant farmers with musculoskeletal pain in a rural community in South-Western Nigeria.

BackgroundAnecdotally, use of Complementary and Alternative Medicine (CAM) for Musculoskeletal Pain (MSP) is common in Nigeria; however, there seems to be a dearth of empirical data on its prevalence and mode of use. This study investigated the prevalence and modes of use of CAM for MSP among farmers in a rural community in South-western Nigeria.MethodsThis cross-sectional survey employed multistage sampling technique guidelines for conducting community survey by the World Health Organization among rural community farmers in Gudugbu village, Oyo State, Nigeria. A questionnaire developed from previous studies and validated by expert reviews was used to assess prevalence and modes of CAM use. Data was analyzed using descriptive and inferential statistics. Alpha level was set at p < 0.05.ResultsA total of 230 consenting rural farmers volunteered for this study with a valid response rate of 93.9 % (n = 216). The lifetime, 12-month and point prevalence of CAM for MSP was 96.8 % respectively. Herbal therapy and massage were the predominant types of CAM therapies among previous (83.8 and 80.1 %) and current CAM users (37.5 and 37.5 %). CAM was largely used as sole therapy for MSP (75.5 %) and also in combination with orthodox medicine (23.6 %), and it is consumed on daily basis (21.8 %). CAM was perceived to be very good in maintaining a healthy life (87.1 %) and has less side effects (74 %) and more healthy than taking doctors’ prescriptions (63.4 %).ConclusionThere is a high prevalence of CAM among Nigerian rural farmers. The most commonly employed CAM for MSP were herbal remedies and massage which are attributable to beliefs on their perceived efficacy.