Integrative Medicine Utilization Research Articles

Integrative medicine utilization among infertility patients

BackgroundPrevious research suggests that some women are using integrative and complementary holistic approaches to optimize their own health and treat infertility. We aimed to determine patterns of integrative medicine use among those seeking fertility optimization by 1) Characterizing patterns of integrative medicine use to increase fertility; 2) Identifying demographic predictors associated with such integrative medicine use; and 3) Exploring cultural and religious influences on use of integrative medicine.MethodsCross-sectional self-reported survey data were collected from 1460 patients presenting to an academic fertility center in Chicago, Illinois. Variables were described with univariate frequencies and proportions, unadjusted bivariate comparisons were made between patient-level factors and reported integrative modality use, and multivariable logistic regression evaluated the strength of covariate-adjusted predictors of reported integrative medicine utilization.Results80.4% of respondents reported using at least one integrative medicine modality to treat infertility (Acupuncture: 38.5%, Yoga: 27.6%, Massage: 25.8%, Meditation: 16.7%, and Herbal supplements: 18.5%). Diet therapy was the most frequently utilized modality (74.0%) followed by body therapy (45.2%), traditional alternative medicine (42.0%), mind therapy (32.1%), and senses therapy (23.0%). Any integrative medicine modality use was 4.03 times more likely among Hindu respondents compared to participants that identified as not religious (95% CI 1.2–13.7, p < 0.026). Significant differences in specific modality use were observed by race, religious affiliation, age, income, and insurance coverage.ConclusionMost infertility patients in our study reported using at least one integrative medicine modality to help them conceive. Utilization was associated with age of participant, religious affiliation, annual income, and insurance coverage. Further research is needed to assess the impact of integrative medicine utilization on patient quality of life and outcomes.

Assessment of the complementary and integrative medicine utilization among patients with multiple sclerosis using a translated and adapted version of the international questionnaire (I-CAM-QP): A cross-sectional study in Southern Iran

AimsTo assess the prevalence of and factors related to complementary and integrative medicine (CIM) use among multiple sclerosis (MS) patients, using a translated and adapted version of a standard international questionnaire. MethodsInternational complementary and alternative medicine questionnaire (I-CAM-Q) was used. A cross-sectional study was done to assess the prevalence of and factors associated with CIM use among MS patients in Southern Iran. Patients who were randomly selected from MS registry center, were interviewed via phone calls. ResultsThree hundred patients were enrolled in the study; 69% of them were female. Their mean age was 36.6±8.53 years and the mean duration of the disease was 5.6 ± 4.22 years. In all, 99.3% (95% CI) of the patients had used at least one type of CIM. Herbal medicines and dietary supplements were the most commonly used CIM type (97.3%; 95% CI). Praying was the most common modality among all CIM subgroups (81.3%; 95% CI). Long term illness (MS) was selected as the main reason for the last use of all CIM types. Having non-tertiary education and having sequel due to MS were related to visiting a CIM provider (adjusted odds ratio (AOR) = 2.32, 95% confidence interval (CI) = 1.22–4.43), (AOR = 2.67, 95% CI = 1.47–4.83) respectively. Being female was related to the use of self-help practices (AOR = 3.41, 95% CI = 1.5–7.72). ConclusionThere is a high prevalence of CIM use among MS patients. Therefore, patient- physician communication about CIM use should be emphasized.

Utilization of integrative medicine differs by age among pediatric oncology patients.

Coping with symptoms related to cancer treatment is challenging for pediatric patients with cancer and their caregivers. Additionally, caring for pediatric patients requires specialized expertise to incorporate age-appropriate interventions to improve outcomes. Despite the increase in pediatric inpatient integrative medicine (IM) therapies, there is a paucity of knowledge about whether the utilization of IM therapies differs by patient age. We conducted a retrospective analysis on IM utilization among pediatric inpatients between 2008 and 2016 in a tertiary urban cancer center using electronic medical records. Multivariable logistic regression models examined the relationship between age and specific type of IM utilization, adjusting for specific demographic factors. Between 2008 and 2016, the pediatric inpatient IM service had 20686 visits and treated 1877 unique patients. A significant age difference (P<0.001) by modality was noted: dance therapy (mean age ± standard deviation: 5.9 ± 5.3 years), music therapy (8.0±7.0 years), mind-body therapies (13.0 ± 7.7 years), massage (14.5 ± 7.8 years), and acupuncture (20.0 ± 7.9 years). In multivariable analysis, the association between age and use of specific IM therapies remained significant (P<0.001 for all). Specific types of inpatient IM therapy usage significantly differed by the age of pediatric patients with cancer; therefore, designing and providing age-appropriate IM interventions with consideration for developmental stage are needed to ensure that the most appropriate and effective therapies are provided to children with cancer.

Survey of Integrative Medicine in Myeloproliferative Neoplasms (The SIMM Study-2)

Background:Polycythemia vera (PV), essential thrombocytosis (ET), and myelofibrosis (MF) are chronic myeloproliferative neoplasms (MPNs) characterized by clonal cell proliferation, splenomegaly, and significant symptom burden. Integrative medicine interventions may offer unique symptom management strategies. (Gowin, et al., EHA 2017). Here we describe integrative interventions utilized and association with symptom burden, quality of life, depression, and fatigue adjusted for lifestyle confounders.Methods:Patients were recruited via social media. Consent and online self-report surveys were completed capturing patient demographics, disease-specific data, integrative medicine utilization, symptom burden via MPN-Symptom Assessment Form Total Symptom Score (MPN-SAF TSS), depression screening via Patient Health Questionnaire (PHQ)-2, fatigue via Brief Fatigue Inventory (BFI), and overall quality of life (QoL). MPN-SAF TSS, QoL, BFI, and PHQ2 were compared by participation in the most frequently utilized interventions (Yes vs No). Intervention comparisons were adjusted for alcohol consumption, smoking status, BMI, current dietary modification, and MPN type using multiple linear and logistic regression.Results:Patients:A total of1087 patient surveys were consented. Of these, 858 had 10 or more responses. See Table 1 for patient characteristics.Integrative Medicine Therapies Descriptive Analysis:Integrative medicine therapies most frequently utilized by patients included aerobic activity (51.5%), massage (28.4%), yoga (25.6%), nutrition (25.2%), strength training (23.8%), acupuncture (19.3%), meditation (19%), breathing exercises (18.4%), chiropractic (16.2%), support groups (14.5%), mindfulness based stress reduction (13.6%), walking meditation (12.0%), pet therapy (9.4%), aromatherapy (8.6%), music therapy (8.0%), progressive muscle relaxation (7.0%), guided imagery (6.4%), homeopathy (6.3%), manual therapy (osteopathy/cranial sacral) (6.2%), reiki (5.8%), therapeutic touch (5.7%), Tai Chi (5.2%), art therapy (4.9%), traditional Chinese medicine (4.3%), Qigong (3.5%), cooking classes (3.0%), laughter therapy (2.9%), Ayurveda (2.4%), biofeedback (2.2%), dance therapy (2.1%), hypnosis (2.0%), resilience training (0.9%), IV vitamin therapy (0.8%), and narrative medicine (storytelling) (0.3%).Diet modification was reported in 47.7% of patients, including Mediterranean diet (19.0%), paleo/high protein/low carbohydrate (8.9%), vegetarian (8.6), plant based (5.2%), gluten free (5.2%), low FODMAP (1.8%), vegan (1.2%), and raw (0.6%) diets. Only 24% of patients reported receiving nutrition advice from their healthcare practitioner (HCP).Supplement utilization by MPN type was 162 patients (48.4%)in ET, 80 patients (42.8%) in MF, and 142 patients (45.2%) in PV. Overall, 20.6% patients reported not disclosing their natural product usage to their HCP. The most frequently utilized supplements included vitamin D, multivitamin, magnesium, omega 3, and calcium.Adjusted symptom association with integrative therapy intervention:MPN symptom burden: Aerobic activity (P=<.001)and strength training (P=.01) was associated with lower mean symptom burden. Use of massage (P=<001) and support groups (P=<.001) was associated with higher levels of symptom burden.QOL:Higher quality of life was reported in those receiving massage (P=.04)and support groups (P=.002). Lower quality of life was noted in those using aerobic activity (P=<.001)and strength training (P=.001).Depression (PHQ-2):Lower depression screening score was noted in those participating in aerobic activity (P=.006), yoga (P=.03), and strength training (P=.02).Fatigue (BFI):Lower fatigue was noted in those participating in aerobic activity (P=<.001) and strength training (P=.03). Higher fatigue was noted in those participating in massage (P=<.001) and breathing techniques (P=.02). See Table 2.Conclusion:In a geographically diverse MPN patient population, and when adjusting for healthy lifestyle practices overall, patterns of lower symptom burden, fatigue, depression, and higher QoL were revealed with integrative medicine utilization. Although limited by gender discrepancy and patient reported data, this study may offer a foundation to structure future integrative medicine trials to complement standard therapies in MPN patients. [Display omitted] DisclosuresGowin:Incyte: Consultancy, Other: Scientific Advisory Board, Speakers Bureau. Mesa:UT Health San Antonio - Mays Cancer Center: Employment; Promedior: Research Funding; NS Pharma: Research Funding; CTI Biopharma: Research Funding; Genentech: Research Funding; Gilead: Research Funding; Incyte Corporation: Research Funding; Novartis: Consultancy; Pfizer: Research Funding; Celgene: Research Funding.

Complementary and Integrative Medicine Utilization Among Rehabilitation Professionals: Attitudes and Practice

To investigate perceptions and utilization of complementary integrative medicine (CIM) by rehabilitation professionals.

Successful integration of palliative care services into the multidisciplinary multiple myeloma clinics: An observational study based on a single institution experience.

142 Background: The pain syndromes, both acute and chronic are prevalent and often the only complaints affecting the patients’ quality of life and functional capacity. Here we describe our experience of successful integration of palliative care service into multiple myeloma (MM) management in a form of the disease specific multidisciplinary clinic. Methods: We have established a dedicated monthly multidisciplinary clinic for all patients diagnosed with symptomatic MM as a pilot project to incorporate different specialties involved in MM care with the goal to improve on disease management, increase compliance with office visits, reduce emergency department visits and benefit a healthcare system. Patients were able to have the same day visits with medical oncologist, radiation oncologists, palliative care physician, integrative medicine and medical psychologist. Over the course of two years (April 2015 through March 2017), we provided care to 39 unique MM patient. Results: After medical/transplant oncology encounters (N = 601), the most encountered specialists were palliative care (N = 208), followed by radiation oncology (N = 34) and integrative medicine/medical psychology (N = 33). The rate of missed office visits for multidisciplinary clinic was 5%, compared to average 7% for all cancer patients at our center. The rates of emergency department visits were rising in proportion to non-compliance with multidisciplinary clinic visits (correlation coefficient 0.43) Conclusions: Patients with MM cared for at the multidisciplinary clinic had better compliance with office visits and fewer unplanned emergency department visits in comparison patients with other oncologic disorders. The rates of emergency departmentvisits were proportional to non-compliance with multidisciplinary clinic visits. The degree of utilization of integrative medicine and psychology was comparable to radiation oncology encounters suggesting that psychological, behavioral, dietary interventions, complementary, physical therapies and rehabilitation have an important and growing role in MM management.

Integrative Medicine for Postoperative Patients: A Survey of Korean Medicine Doctors.

The purpose of this survey was to document the experience of Korean Medicine doctors (KMD) who provided postoperative care to patients through integrative medicine and to understand their opinions about integrative medicine utilization. Three researchers (two with a KMD license) of the Korea Institute of Oriental Medicine conducted the survey. The questionnaire was distributed via e-mail to the 17,041 members of the Association of Korean Medicine in 2015. In total, 487 KMD answered the questionnaires. The majority of respondents worked in a Korean Medicine (KM) clinic, KM hospital, or long-term care hospitals (94.7%). The respondents mostly treated patients after musculoskeletal (26.7%), spinal (23.7%), or neuropathic surgery (22.2%). Patients predominantly experienced pain (23.0%), fatigue and tiredness (17.4%), delayed scar recovery (13.7%), and paralysis (13.0%). We analyzed subgroups in accordance with institution of employment, specialization, and clinical experience. Most KMD wanted to utilize integrative medicine for postoperative care of patients (92.6%). Moreover, a relatively active collaboration was noted in long-term care hospitals (mean rate: 60.73% [95% CI: 42.25 to 79.20]). Further studies and clinical trials are needed to determine whether integrative medicine is essential for providing postoperative care to Korean patients.

Integrative Medicine in Head and Neck Cancer.

Objective Complementary and alternative medicine, or integrative medicine, has become increasingly popular among patients with head and neck cancer. Despite its increasing prevalence, many patients feel uncomfortable discussing such therapies with their physicians, and many physicians are unaware and underequipped to evaluate or discuss their use with patients. The aim of this article is to use recent data to outline the decision making inherent to integrative medicine utilization among patients with head and neck cancer, to discuss the ethical implications inherent to balancing integrative and conventional approaches to treatment, and to highlight available resources to enhance head and neck cancer providers' understanding of integrative medicine. Data Sources Randomized controlled trials involving integrative medicine or complementary and alternative medicine treatment for cancer patients. Review Methods Trials were drawn from a systematic PubMed database search categorized into cancer prevention, treatment, and symptom management. Conclusions Integrative medicine is gaining popularity for the management of cancer and is most commonly used for symptom management. A number of randomized controlled trials provide data to support integrative therapies, yet physicians who treat head and neck cancer may be faced with ethical dilemmas and practical barriers surrounding incorporation of integrative medicine. Implications for Practice In the management of head and neck cancer, there is an increasing demand for awareness of, dialogue about, and research evaluating integrative medicine therapies. It is important for otolaryngologists to become aware of integrative therapy options, their risks and benefits, and resources for further information to effectively counsel their patients.

Integrative Health and Healing Practices Specifically for Service Members: Self-Care Techniques

Abstract Background: There has been an ever-increasing utilization of integrative medicine (IM) by patients to manage their health. Dissatisfaction with depersonalized care is one of the significant factors causing patients to seek alternative means to meet their health care needs. These patients are often motivated to find care that coincides with their beliefs, values, and expectations. Medical health care systems must understand these concerns and work collaboratively with patients to achieve optimal outcomes and satisfaction levels. Self-care programs, when part of holistic treatment plans, are well-suited to address these concerns. Objective: This article discusses the concepts of self-care, and active and passive participation, as well as briefly examining some IM modalities that can be used as self-care techniques. Methods: This overview describes the history, concepts, uses, and relevant research of several IM modalities and their applications as self-care techniques. Recommendations for education...