Form Of Complementary And Alternative Medicine Research Articles

Assessing clinician familiarity with integrative oncology and uptake of an electronic medical record–based education resource.

e21001 Background: Integrative oncology is the practice of incorporating complementary and alternative medicine (CAM) into the conventional care of cancer. CAM encompasses a broad realm of treatment modalities, ranging from nutrition and exercise to acupuncture, supplements, and behavioral therapy. Few oncologists discuss CAM with their patients while patients under-report their usage of these treatments to their oncologists. Our project aim was to assess clinician familiarity with integrative oncology and to improve education on the topic using a clinician-facing tool accessible through the electronic medical record (EMR). Methods: We distributed a survey from May through July 2023 to assess attitudes towards CAM and practice patterns at an academic oncology department. Respondents used a five-point Likert scale to rate their understanding of CAM, role in counseling patients on CAM, and factors affecting their discussion of such topics. We created EMR-accessible clinician guides which reviewed the evidence base for common complementary treatments in breast, colon, and lung cancer. Results: Fifteen of 64 (23%) affiliated oncologists completed the survey. Eleven (73%) respondents agreed or strongly agreed that it is their responsibility to learn about CAM. Fourteen (93%) respondents agreed or strongly agreed that it is their responsibility to ask patients about CAM usage, although two-thirds of respondents initiated conversations about CAM “sometimes” or less. Six (40%) felt comfortable providing resources on CAM to their patients. Respondents reported greatest awareness of the evidence for exercise and psychotherapy (average rating 3.8 out of 5; higher is more familiar) and least awareness for supplements (average 3.2). The factors most strongly affecting respondents’ practices of discussing CAM with patients were a lack of credible resources and fear that supplements might replace conventional cancer treatment. Ten (67%) respondents reported that patients undergoing active treatment often or always ask about CAM and nine (60%) reported that survivors often or always ask about CAM. Three practicing oncologists and two fellows had added our clinical guides to their EMR shortcuts six months after their introduction. Conclusions: Certain forms of CAM remain controversial within oncology practice. Although oncologists in our department reported a sense of responsibility to understand and counsel patients on CAM, multiple barriers impeded physician comfort with the topic and uptake of a novel educational resource was limited. Patients undergoing active treatment and survivors alike asked clinicians about CAM, which suggests it is an important area of competence for oncologists regardless of treatment phase.

Assessment of Knowledge and Communication Regarding Complementary and Alternative Medicine Among Physicians in Madinah City.

Despite the recognition of the importance of physician knowledge andphysician-patient communication about the use of complementary and alternative medicine (CAM), few studies have explored this issue. Therefore, this study aims to assess physicians' knowledge and physician-patient communication regarding CAM. A cross-sectional study was conducted among physicians working at governmental hospitals and primary healthcare centers in Madinah, Saudi Arabia. The data collection tool was a validated English language questionnaire distributed using social media platforms. The questionnaire included sections to assess physician knowledge and communication about CAM. Of the 373 completed questionnaires, around 151 (40.5%) of the respondents stated that they have a poor level of knowledge about CAM, and 272 (72.9%) need to gain additional knowledge to properly counsel patients on CAM. Medical journals were the main source of knowledge about CAM. There were 121 (32.4%) physicians who believed that <20% of their patients use some form of CAM, and 180 (48.3%) believed that <20% of their patients spontaneously reported their CAM use without prompting or direct questioning. Around 180 (48.3%)of physicians believed that they asked <20% of their patients about using CAM. Regarding barriers that limit communication with the patient about CAM, the highest percentage was insufficient knowledge about CAM (137, 36.7%). The study showed that a significant number of physicians lack the appropriate knowledge about CAM and most of them agreed to gain additional knowledge to properly counsel their patients.Further research is needed to evaluate physicians' knowledge about CAM using a more objective method.

Use of Complementary and Alternative Medicine in Patients with Rare Bone Diseases and Osteoporosis.

(1) Background: The use of complementary and alternative medicine (CAM) has seen a notable increase in popularity. However, there is an absence of data regarding the prevalence of CAM use in patients with rare bone diseases (RBDs). (2) Methods: This monocentric, cross-sectional study was carried out in a reference hospital for RBDs. RBD patients included individuals with osteogenesis imperfecta, hypophosphatasia and X-linked hypophosphatemia, and their data were compared with those of patients with osteoporosis (OPO) and of healthy controls (CON). This study utilized the German version (I-CAM-G) of the I-CAM questionnaire. (3) Results: This study comprised 50 RBD patients [mean age (SD) of 48.8 (±15.9), 26% male], 51 OPO patients [66.6 (±10.0), 9.8% male] and 52 controls [50.8 (±16.3), 26.9% male]. Treatments by naturopaths/healers were more prevalent in the RBD group (11.4%) compared with OPO (0%) and CON (5.8%) (p = 0.06). More than half of the OPO (60.8%) and CON (63.5%) patients and 46% of the RBD patients reported vitamin/mineral intake within the past 12 months (p = 0.16). Individuals with tertiary education had a significantly higher odds ratio of 2.64 (95% CI: 1.04-6.70, p = 0.04) for visiting any CAM provider. Further, OPO patients were significantly less likely to use self-help techniques compared with the CON group (OR = 0.42, 95% CI: 0.19-0.95; p = 0.04). (4) Conclusions: Herbal medicine, vitamin and mineral supplements, and self-help techniques were the most common forms of CAM reported by patients with RBDs. However, the use of CAM was generally low.

Complementary and alternative medicine use among kidney transplant patients in Turkey; prevalence, clinical features and outcomes

IntroductionOur aim in this study to evaluate the prevalence, types of complementary and alternative medicine (CAM) and outcomes among patients kidney transplant recipients in our country. MethodsThis is a cross-sectional study was conducted from May 2019 to May 2020 in the nephrology outpatient clinics of five different university hospital. They answered a self-administered a survey questionnaire, this form is included questions on socio-demographic and clinical features and on the CAM therapies. ResultsA total of 830 patients (496 [59.8%] males, 334 [40.2%] females; mean age 43.9 ± 9.4 years) kidney transplantation recruited for the study. One hundred ninety-two (22.8%) of the patients reported the use of one or more forms of CAM. Meanwhile, 64.5% of CAM users did not report their CAM therapies to their physicians. There was a significant correlates for CAM users were older age (P = 0.00; odds ratio (OR) = 0.76; 95% CI = 0.88–0.93), occupational status (P = 0.045) and monthly income (P = 0.021; odds ratio (OR) = 2.18; 95% CI = 1.42–3.3). ConclusionsWe determined that every five of one kidney transplant patients were using one type of CAM. Some of these CAMs are potentially harmful and may affect patient compliance to immunosuppressive therapies. Physicians should ask questions about CAM to patients on visit days and should explained their knowledge about CAM therapies.

Predicting Herb-disease Associations Through Graph Convolutional Network

Background: In recent years, herbs have become very popular worldwide as a form of complementary and alternative medicine (CAM). However, there are many types of herbs and diseases, whose associations are impossible to be fully revealed. Identifying new therapeutic indications of herbs, that is drug repositioning, is a critical supplement for new drug development. Considering that exploring the associations between herbs and diseases by wet-lab techniques is time-consuming and laborious, there is an urgent need for reliable computational methods to fill this gap. : In this study, we first preprocessed the herbs and their indications in the TCM-Suit database, a comprehensive, accurate, and integrated traditional Chinese medicine database, to obtain the herb-disease association network. We then proposed a novel model based on a graph convolution network (GCN) to infer potential new associations between herbs and diseases. Methods: In our method, the effective features of herbs and diseases were extracted through multi-layer GCN, then the layer attention mechanism was introduced to combine the features learned from multiple GCN layers, and jump connections were added to reduce the over-smoothing phenomenon caused by multi-layer GCN stacking. Finally, the recovered herb-disease association network was generated by the bilinear decoder. We applied our model together with four other methods (including SCMFDD, BNNR, LRMCMDA, and DRHGCN) to predict herb-disease associations. Compared with all other methods, our model showed the highest area under the receiver operating characteristic curve (AUROC), the area under the precision-recall curve (AUPRC), as well as the highest recall in the five-fold cross-validation. Conclusion: We further used our model to predict the candidate herbs for Alzheimer's disease and found the compounds mediating herbs and diseases through the herb-compound-gene-disease network. The relevant literature also confirmed our findings.

Complementary and Alternative Medicine (CAM): use and views among patients with solid organ and haematological malignancies in Northland, New Zealand.

Complementary Alternative Medicine (CAM) use among patients with malignant diagnosis has been rising globally. This study assesses the prevalence of CAM among patients with solid organ or haematological malignancy at a regional outpatient cancer and blood service in Northland, New Zealand. Secondary objectives include determining: i) types of CAM used, ii) sources of information, and iii) patient perspectives on CAM. In this single-centre cross-sectional study, patients attending treatment or follow-up appointments at the Jim Carney Cancer Treatment Centre (JCC) between 25 September to 20 October 2017 were invited to complete an anonymous self-administered questionnaire. Of the 306 assessable entries, 29% (n=89) respondents were using CAM, 10% had intentions to use CAM in the future, while 45% were undecided. Word-of-mouth (58%) was the most common source of CAM information, followed by internet sources (36%) and healthcare professionals (27%). Biologically based therapies were the most popular form of CAM used. Common reasons for CAM use include symptom relief (65%), perceived lower toxicity (62%), holistic (52%), natural (51%) and potential for cure (45%). Only 49% of CAM users felt comfortable discussing their CAM use with their oncologist/ haematologist. CAM use is common and has relevance across oncology treatment centres nationwide. Local research into CAM use can serve to raise awareness and to assist healthcare professional training in addressing CAM use in a specific patient population.

Abstract P645: Lower Satisfaction With Healthcare Providers’ Communication Associated With African Americans Seeking Care From Complementary and Alternative Medicine Providers: The Jackson Heart Study

Introduction: Individuals who use complementary and alternative medicine (CAM) have been found to have a greater sense of agency and control over their health, a goal that mainstream healthcare providers are also encouraged to promote through patient- centered communication. Patient-centered communication helps patients to feel heard, understood, and involved in their health decisions. The relationship between patient-centered communication and the use of CAM by African Americans has not been previously described. Hypothesis: African Americans who report less satisfaction with their healthcare providers’ communication will be more likely to seek CAM providers. Methods: This was a secondary analysis of data from the Jackson Heart Study, a longitudinal cohort study of African Americans in the Jackson, Mississippi metropolitan area. We performed a cross-sectional analysis of annual follow up data collected between 2004 and 2006. The exposure variables included participants’ satisfaction with their healthcare providers’ communication, which was captured by four items, which asked: “How often did your doctor or other healthcare providers listen carefully to you/explain things in a way you could understand/show respect for what you had to say/spend enough time with you.” These items were summed into a provider communication satisfaction index, with higher scores representing greater satisfaction. The outcome variables included whether the respondent had seen a CAM provider such as an acupuncturist, faith healer, or person who works with roots/herbs, in the previous year. Covariates included education, income, medication insurance status, sex, and age. The final analytic sample after listwise deletion was 2,999. Results: Few JHS participants reported having sought CAM provider options: 0.53% (95% CI: 0.33, 0.87) of participants reported having seen a person who uses acupuncture, 0.50% (95% CI: 0.30, 0.83) of participants reported having seen a faith healer, and 0.60% (95% CI: 0.38, 0.95) of participants reported having seen a person who deals with roots or herbs in the previous year. The provider communication satisfaction index, sum of the four provider satisfaction measures, ranged from 4 to 16 (mean: 14.84, SD: 2.09, 95% CI: 14.77, 14.92). Participants who indicated higher levels of satisfaction with their healthcare providers’ communication had lower odds of having seen a person who works with roots or herbs in the previous year (OR: 0.83, 95% CI: 0.70, 0.99, p= 0.036). Associations between the provider communication index and use of other forms of CAM (i.e, faith healing, acupuncture) were not statistically significant. Conclusions: Overall, this study indicates that patient satisfaction with provider communication is associated with African American patients’ exploration of care from CAM providers, particularly those who work with roots and herbs.

Disclosure of Complementary and Alternative Medicine Use Among Older Adults: A Cross-Sectional Study.

Background: Although use of complementary and alternative medicine (CAM) is rising among older adults, many do not discuss these healthcare practices with their primary care practitioners (PCPs). This study sought to determine the prevalence of CAM use and to identify factors associated with CAM disclosure among patients ages 65 and older. Methods: Participants completed an anonymous survey, which evaluated their CAM use over the past year and disclosure of CAM to a PCP. Additional questions queried demographics, patient health, and relationships with one's PCP. Analyses included descriptive statistics, chi-square tests and logistic regression. Results: One hundred seventy-three participants answered surveys. Sixty percent reported use of at least one form of CAM in the past year. Among those using CAM, 64.4% disclosed use to their PCP. Patients disclosed supplements/herbal products and naturopathy/homeopathy/acupuncture at a higher rate than body work techniques and mind-body practices (71.9% and 66.7% vs. 48% and 50%). The only factor significantly associated with disclosure was trust in one's PCP (odds ratio = 2.97; confidence interval = 1.01-8.73). Conclusions: Clinicians may improve CAM disclosure rates in older adults by inquiring about all types of CAM and continuing to invest in their patient relationships, specifically by building trust.

Use of Complementary and Alternative Medicine in the General Public of Western Saudi Arabia: A Cross-Sectional Survey.

Complementary and alternative medicine (CAM) has been continuously used worldwide. Various cultures have used this path of healing, and to our date, people are still using it and some even prefer it to modern medicine.Thus, this study aims to analyze awareness, self-use, perceptions, beliefs, and attitudes toward CAM in the general public of Jeddah, Saudi Arabia. A descriptive observational cross-sectional study was conducted in the public places of Jeddah. Data were collected from 784 participants using a self-administered paper-based questionnaire, and statistical analysis was performed using Statistical Package for the Social Sciences (SPSS). The majority of the population was aware of massage (91.8%), herbs (90.7%), nutritional supplements (89.8%), and prayers (88.1%). With regards to usage and effectiveness, prayers and spirituality is used by 75.5% of the population and considered to be the most effective by 76.0%. Respondents obtained information about CAM mostly from friends and relatives (76.6%), followed by media (67.2%), while lack of knowledge about CAM and lack of trained professionals are the most perceived barriers to CAM implementation. Data showed a significant association (p < 0.05) between gender, awareness, and self-use of CAM modalities. Yoga (44.2%) and herbs (72.6%) were mostly used by females, whereas males were mostly aware of cupping (90.4%) and cauterization (76.2%). Another significant association was found between the level of education,awareness, and self-use of CAM modalities indicating that those who were not educated were aware of and used cauterization the most, while those who went to college were more aware of yoga (75.4%). Lastly, having a relative in the healthcare field showed a significant association with awareness of yoga, prayers, andspirituality compared to other CAM modalities. In conclusion, the present study revealed that the majority of the Western Saudi Arabian population was aware of several CAM modalities and practiced some form of CAM. However, awareness of specific types of CAM may relate to gender, educational level, and relationship to the medical field.

Opinions and experiences of physicians regarding complementary and alternative medicine (CAM). A research report from Poland

Background: The term CAM denotes complementary and alternative medicine. However, CAM is practiced by individuals without academic medical education and formal eligibility for treating people. The extent of interest in CAM is considerable. The WHO global report on traditional and complementary medicine has demonstrated that 87% of all WHO Member States legally recognise individual forms of CAM, and 100 Member States have national policies regarding such practices. In Poland, performing medical activities without appropriate qualifications is prohibited.&#x0D; Material and Methods: Diagnostic survey distributed as Google Forms was used as the basic research method with the research technique of a questionnaire. The questionnaire starting with a metrics part consisted of several questions regarding popularity and tendency of CAM, causes of CAM popularity, approach to those types of practices and patients as well as role of CAM during the pandemic. Sixty-one responses were obtained from physicians of different age, experience and speciality.&#x0D; Results: Ninety-five percent (95%) of doctors believe that alternative medicine can be dangerous; 67.2% think that the phenomenon of alternative medicine should be combated; almost half of the physicians surveyed believe that there is a fundamental contradiction between evidence-based medicine (EBM) and alternative medicine. Furthermore, according to 48% of respondents, physicians in Poland should be able to recommend and combine methods of traditional and alternative medicine.&#x0D; Conclusion: Doctors point to the increasing popularity of CAM among patients in Poland, the consequences of which cannot be determined because there is still a lack of research on the safety of alternative methods. The most frequently cited reasons for interest in CAM suggest that there is a need for a better tailored biomedical approach to individual patient needs.

Quality of life in terminally ill cancer patients: what is the role of using complementary and alternative medicines?

Background and purposeCancer is the world’s second greatest cause of mortality and a leading cause of death in both developed and developing countries. Patients employ a number of complementary and alternative medicine (CAM) methods to deal with the problems and difficulties of cancer, which can have an impact on their quality of life (QOL). The aim of the present study was to assess the correlation between QOL and the use of different CAM methods in terminally ill cancer patients.MethodsThis was a cross-sectional study. In southern Iran, 238 individuals with advanced cancer were studied in oncology centers and doctors’ offices. During the months of January to August 2021, patients were selected using convenience sampling. A demographic information questionnaire, the EORTC core quality of life questionnaire, and the CAM questionnaire were used to collect data.ResultsThe results showed that terminally ill cancer patients had a good quality of life. Last year, 85.7% of participants used at least one kind of CAM. Furthermore, 45.4% of participants used only one form of CAM, 30.3% used two types of CAM, 6.7% used three types of CAM, and 3.4% used four to five types of CAM. When all CAM users were compared to non-CAM users, CAM users had significantly higher social QOL and overall quality of life. Two subscales of QOL symptoms and function were correlated with cancer history, income, and use of CAMs, and the scores of QOL symptoms and function were greater in CAM users compared to non-CAM users. Among all the study variables, only the usage of CAM was correlated to overall QOL among terminally ill cancer patients.ConclusionThe current study found that using CAM could affect different aspects of QOL in terminally ill cancer patients. As a result, it is feasible that using CAM could help these people enhance their health and QOL.

Use of Complementary and Alternative Medicine in the context of cancer; prevalence, reasons for use, disclosure, information received, risks and benefits reported by people with cancer in Norway

BackgroundResearch exploring the use of specific Complementary and Alternative Medicine (CAM) modalities by Norwegian cancer patients is sparse. The aims of this study were therefor to map the different CAM modalities cancer patients use and further investigate their rationale for use, communication about use, self-reported benefits and harms, and their sources of information about the different modalities.MethodsIn cooperation with the Norwegian Cancer Society (NCS), we conducted an online cross-sectional study among members of their user panel with present or previously cancer (n = 706). The study was carried out in September/October 2021 using a modified cancer-specific version of the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). In total, 468 members, 315 women and 153 men, agreed to participate resulting in a response rate of 67.2%. The study was reported in accordance with the National Research Center in Complementary and Alternative Medicine’s (NAFKAM) model of reporting CAM use.ResultsA large proportion of the participants (79%, n = 346) had used some form of CAM with a mean of 3.8 modalities each (range 1-17); 33% (n = 143) had seen a CAM provider, 52% (n = 230) had used natural remedies, while 58% (n = 253) had used self-help practices. Most of the participants used CAM to increase their quality of life, cope with the cancer disease or for relaxation/well-being (64%-94%), mostly with high satisfaction and low rates of adverse effects. Few used CAM to treat cancer or prevent it from spreading (16%, n = 55). The main information sources were health care providers (47%), the internet (47%), and family and friends (39%). More than half (59%) of the cancer patients discussed their use of at least one CAM modality with a physician.ConclusionsThe results of this survey will provide health professionals with more in-depth insight into the patterns of CAM use by cancer patients and facilitate better-informed discussions with their patients. Considering the high use of CAM, reliable information provision supporting cancer care providers’ knowledge and health literacy among patients as well as good communication are crucial. The cooperation between the NCS and NAFKAM provides an example of how to address these issues.

INTEGRATIVE DENTISTRY –WHAT, WHEN AND HOW

The Indian medical system and ministry of AYUSH recognizes Ayurveda, Yoga, Unani Siddha and Homeopathy (AYUSH) as CAM (Complementary and alternative medicine) and also promote organizations/institutions that practice AYUSH health services and research. Various oral pathologies have been explained in Ayurveda with treatment. Yoga is a mind-body medicine, considered to be originated from India. Similarly other forms of CAM like siddha, Unani, homeopathy, naturopathy, acupressure/acupuncture, Reiki, pranic healing etc., have preventive and curative effect for oral diseases and can be used as an adjunct in general dentistry. This is a short summary of complementary and alternative medicines which can be integrated with dentistry.

Prevalence of Complementary and Alternative Medicine Use in Professional Voice Users

Objectives To determine the prevalence and specific modalities of complementary and alternative medicine (CAM) by professional voice users (PVUs) for vocal ailments and to examine the PVU's health care utilization. Methods A Canadian national cross-sectional survey was conducted. Surveys were distributed electronically to members of the Alliance of Canadian Cinema, Television, and Radio Artists; the National Association of Teachers of Singing; the Canadian Actors Equity Association; and the Department of Vocal Performance at Western University. Participants were asked about the products/therapies they use to improve vocal health. Frequency of use, health care utilization, and general influencers in treatment choice were also collected. Results Two hundred eighty-eight participants completed the survey. 86% of participants claimed to have taken at least one form of CAM when experiencing voice loss or a negative voice change. Of the respondents, 18% claimed to use products/therapies for vocal health routinely in the absence of vocal ailments. The most common CAMs used were hot drinks with honey and/or lemon, lozenges, and inhaling steam. When vocally ill, PVUs were significantly more likely to use CAMs than any other treatment method. Voice teachers and medical doctors most commonly influenced the choice of the treatment. Conclusion This study illustrated the substantial prevalence of CAMs in the PVU community. Understanding the utilization of CAMs can help clinicians navigate treatment strategies for this patient population.

Parent Acceptability and Use of Complementary and Alternative Medicine to Manage Children's Post-Tonsillectomy Pain

<h3>Introduction</h3> Complementary and Alternative Medicine (CAM) interventions, such as honey, have been well-documented in reducing pain following tonsillectomy procedures. <h3>Identification of the problem</h3> CAM is oftentimes overlooked when it comes to the treatment of pain, particularly when it comes to children. With the new restrictions placed on opioid prescribing, more research is needed to find alternative ways to manage children's pain. <h3>Purpose of the Study</h3> Our study aimed to assess parents' CAM use for their own health and their child's health. Further, we assessed parents' willingness to use various forms of CAM for their child's health in the future. <h3>Methodology</h3> Parents (n = 64) were recruited by a nurse at the time of their child's tonsillectomy procedure to participate in a study on CAM and children's postoperative pain. Following informed consent, parents completed online surveys through REDCap about their use of CAM, CAM beliefs, and willingness to use CAM for their child's health. <h3>Results</h3> Over half of parents (62.5%) reported using CAM for their own health. Parents had tried an average of 3.2 (SD = 3.38) forms of CAM (most common: natural supplements, chiropractic or massage, and relaxation strategies). Similarly, parents had tried an average of 2.12 (SD = 2.60) forms of CAM for their child's health with 59.4% of parents trying at least one form of CAM for their child. Most commonly used forms of CAM for children were honey of bee products (37.5%), aromatherapy (34.3%), and natural supplements (26.5%). <h3>Discussion</h3> The majority of parents had some experience with CAM interventions and had tried CAM for their child's health. However, a significant minority of parents had never tried CAM interventions. <h3>Conclusion</h3> CAM interventions could be acceptable to parents for use in managing children's pain. Honey appears to be the most commonly tried form of CAM for children and could have potential utility for use following tonsillectomy procedures. <h3>Implications for perianesthesia nurses and future research</h3> Families overall are open to CAM and could use further education regarding how to best use CAM to manage children's postoperative pain. Future research will evaluate the efficacy of honey for controlling postoperative pain and reducing need for opioids following tonsillectomy.

Complementary and alternative medicine in children with diffuse intrinsic pontine glioma-A SIOPE DIPG Network and Registry study.

Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a 2-year survival rate of <10%. This international survey study aims to evaluate the use of complementary and alternative medicine (CAM) in this patient population. Parents and physicians of patients with DIPG were asked to participate in a retrospective online survey regarding CAM use during time of illness. Between January and May 2020, 120 parents and 75 physicians contributed to the online survey. Most physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported using CAM to treat their child during time of illness. Cannabis was the most frequently used form of CAM, followed by vitamins and minerals, melatonin, curcumin, and boswellic acid. CAM was mainly used with the intention of direct antitumor effect. Other motivations were to treat side effects of chemotherapy or to increase comfort of the child. Children diagnosed from 2016 onwards were more likely to use CAM (χ2 =6.08, p=.014). No significant difference was found between CAM users and nonusers based on ethnicity (χ2 =4.18, p=.382) or country of residence (χ2 =9.37, p=.154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. This survey demonstrates that worldwide, a considerable number of patients with DIPG use CAM. Physicians should be more aware of potential CAM use and actively discuss the topic. In addition, more research is needed to gain knowledge about possible anticancer effects of CAM and (positive/negative) interactions with conventional therapies.

Complementary and Alternative Medicine: Reliable Websites for Consumers

Complementary and Alternative Medicine (CAM), also referred to as Complementary and Integrative Medicine, refers to treatments outside of mainstream medicine. There are many forms of CAM, including mind-body and herbal supplements. This paper presents a variety of reliable CAM websites that may be of interest to consumers, including sites that help evaluate CAM treatments. Those providing CAM information to consumers must stress the importance of speaking with a healthcare provider to determine if the treatment is safe for the consumer.

From “Unbelievable Stupidity” to “Secret Clues for Staying Healthy”: CAM Landscape and Boundary-Work in Estonian and Finnish Mainstream Media in April 2020

Based on a one-month (April 2020) comparative observation of media content in three Estonian and three Finnish mainstream media sources (two daily newspapers and one weekly women’s magazine) along with some examples from an earlier period, the authors analysed the representation of complementary and alternative medicine (CAM) in the media. The analysis showed that the media from the two countries presented CAM both in its various mainstream and more fringe forms, and that pejorative as well as complimentary and attracting undertones were present. The authors conclude that CAM topics were present in the selection of sources as methods for wellbeing and healing but also as entertaining, exoticising, warning, and mystical-metaphorical allusions along with different levels of boundary-work, especially science. The authors also noted interesting differences between the chosen media both within one country and between the two countries in terms of how much CAM was present as well as in which ways it was treated. In the Estonian material, the scale of tones was broader: the texts presented highly sensational, exoticising and othering angles towards approaches that were considered extreme and dangerous but mainly entertainment-oriented, and they positively described healing and wellbeing practices, sometimes with a mystic touch. The Finnish media was more low-key in its representations and tone: the mentions were shorter and less frequent. Although the Finnish material had more positive representations, this does not suggest that CAM is more tolerated in Finland – the Finnish media presented less extreme forms of CAM, which gave less ground for journalistic opposition.

DIPG-84. COMPLEMENTARY AND ALTERNATIVE MEDICINE IN DIFFUSE INTRINSIC PONTINE GLIOMA

INTRODUCTIONDiffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a two-year survival rate of ≤10%. In this international survey study we aim to evaluate the use of complementary and alternative medicine (CAM) in this patient population.METHODSParents of-, and physicians treating DIPG patients were asked to participate in a retrospective online survey with questions regarding CAM use during time of illness.RESULTS120 parents and 75 physicians contributed to the online survey between January and May 2020. Physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported to have used CAM to treat their child during time of illness. Cannabis was the most widely used form of CAM, followed by vitamins and minerals, melatonin, curcumin and boswellic acid. CAM was mainly used to actively treat the tumor. Other motivations were to treat side effects of chemotherapy, or to comfort the child. Children diagnosed ≥2016 were more likely to use CAM (χ2=6.08, p=0.014). No significant difference was found between CAM users and non-users based on ethnicity (χ2=4.18, p=0.382) and country of residence (χ2=9.37, p=0.154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use.CONCLUSIONThis survey demonstrates that worldwide a considerable number of DIPG patients use CAM. Physicians should be more aware of potential CAM use and more actively discuss the topic. More research is needed to gain knowledge about possible anticancer effects of CAM and their interactions with conventional therapies.

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.