Types Of Complementary And Alternative Medicine Therapies Research Articles

Use of Complementary and Alternative Medicine for Prostate Cancer among African Americans, African Immigrants and Caribbean Immigrants.

Black men have the highest rate of prostate cancer (PCa) morbidity and mortality in the US, and often receive delayed and/or poorer-quality treatment. This inequity has led many to turn to complementary and alternative medicine/therapies (CAM). However, little is known about the use of these therapies within the Black community. The purpose of this study was to describe types of CAM therapies used, and the reasons behind their use for overall health and PCa treatment and prevention among three groups of Black males, namely African Americans, Caribbean Immigrants and African Immigrants. This study used a mixed-methods design with a quantitative phase (n = 575) followed by a qualitative phase (n = 61) with participants recruited from various parts of the country. Results revealed differences among subgroups in CAM use for overall health and PCa, as well as differences in the types of CAM therapies used and differences in the reasons behind their use. The findings of this study reveal a prevalence of CAM use for overall health and PCa within three different groups of Black men and identifies the specific CAM used. There were significant differences in the types of CAM used by each subgroup for both overall health and PCa. This study also shows that there is value in looking at Black subgroups distinctively, for their rates of CAM use and reasons for use, are distinctly different.

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

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

A Hospital-based Study of the Prevalence and Usage of Complementary and Alternative Medicine Among Saudi Psychiatric Patients.

IntroductionComplementary and alternative medicine (CAM) therapies, used singularly or in combination with more conventional therapies, are routinely used by citizens of the Kingdom of Saudi Arabia (KSA) for medical care or seeking wellness. However, the prevalence of CAM therapies among Saudi psychiatric patients is not yet documented. To better understand the importance of CAM in today’s medical field, particularly within the KSA and for psychiatric patients, this descriptive study aims to characterize the use of CAM therapies by a sample of psychiatric patients in the KSA.MethodsThis cross-sectional hospital-based study describes the use of CAM therapies by Saudi psychiatric patients being treated at one of the largest government hospitals in the KSA. Using a pretested questionnaire, adult psychiatric patients waiting for their appointment or during their stay at a government hospital in Riyadh were interviewed regarding the use of CAM therapies after agreeing to participate.ResultsForty-five adult psychiatric patients agreed to participate in this study. The average age of the participants in the study was 35. Of the participants, 62% were females, 91.1% were outpatients, and 44.4% were diagnosed with depression. Moreover, 82.2% of the participants reported using one or more types of CAM therapies within the past year to address mental illness. Of those who used CAM therapies, 62.2% did so to improve their quality of life; 59.5% did so for treatment, supportive treatment, or both, and 54.1% used CAM therapies to help control symptoms. The most frequent CAM therapies used by psychiatric patients were spiritual therapies such as Quran recitation; body therapies, mainly exercise; and mind therapies, mainly relaxation techniques. These CAM therapies were used mainly as treatments or supportive treatments for depression. Most of the participants who used CAM therapies were satisfied with the use of these therapies (75.7%). Finally, 45.9% of the participants had not discussed the use of CAM therapies with their doctors, primarily because of their reluctance to share private information, especially spiritual matters, with the treating physicians.ConclusionsThe study results suggest a high prevalence of CAM therapy use among Saudi adult psychiatric patients, as well as a high level of satisfaction with such therapies. However, since about half of the patients had not discussed the use of CAM therapies with their physicians, and since some of the CAM therapies may cause unfavorable interactions when used alongside certain medications or medical interventions, healthcare providers should be diligent about inquiring of their psychiatric patients any use of CAM therapies, not only during the initial visit but also during the follow-up visits as well.

Prevalence of use of complementary and alternative medicine in chronic kidney disease: A cross-sectional single-center study from South India

The prevalence of chronic kidney disease (CKD) has increased substantially in India over the past two decades commensurate with the global trend and has currently emerged as a significant cause of mortality and morbidity. Use of complementary and alternative medicine (CAM), especially ayurvedic medication, is widespread in CKD although accurate data on the prevalence of use are lacking. A cross-sectional study was conducted from January to June 2017 in the nephrology outpatient clinic of a medical college hospital in Mangalore, South-West India. Adult patients (>18 years) with CKD (estimated glomerular filtration rate ≤60 mL/min) were considered potentially eligible and approached to participate in the survey. A 17-item semi-structured questionnaire adapted from the National Health Interview Survey Adult CAM Supplement was used for the study. A total of 278 patients (194 males and 84 females) with a mean age of 49.04 ± 12.06 years were included in the study; 67.3% were unemployed and married (83.8%), 35.6% had primary school education, more than 2/3rd of the patients had CKD Stage 5, and 110 patients were on renal replacement therapy with hemodialysis. Comorbidities such as hypertension were present in 46.8%, whereas 36.7% of the patients were diabetic. One hundred and eighty-four patients interviewed (66.3%) reported the use of one or more types of CAM therapy in the previous six months. Herbal and dietary supplements were used by 13 (7.1%); ayurvedic medication by 117 (63.6%); naturopathic, homeopathic, and Unani systems by 30 (16.3%), while spiritual/faith healing and acupuncture were used by 16 (8.7%) and eight (4.3%) of the patients, respectively. A multiple regression analysis between CAM users and non-users revealed that older age (P = 0.004), occupational status (P = 0.035), and income (P = 0.006) correlated strongly with CAM use. The present study highlights the high prevalence (66%) of use of alternative medication in patients with CKD.

A caregiver perspective of complementary and alternative medicine use among patients with schizophrenia and bipolar disorders

The World Health Organization estimates that about 40%–60% of patients with mental illness use Complementary and Alternative Medicine (CAM), but little is known about the types and outcomes of these CAM therapies in Ghana. This study therefore sought to describe the patterns of use and perceived outcome of CAM therapy among patients with schizophrenia and bipolar disorders in a health facility in Ghana. The qualitative study involved both clinical and family caregivers of patients with schizophrenia and bipolar disorders. Semi-structured interviews were conducted over a period of 3 months to identify the pattern of CAM use and perceived outcome from caregiver perspectives. The interviews were audio recorded, transcribed and analyzed thematically using NVivo 10. About 92% of family caregivers reported that their patients had used some form of CAM therapy. The therapies used included spiritual interventions (100%) herbal therapies (83%), dietary supplements (50%) and music therapies (6%). Both clinical and family caregivers perceived CAM therapies to be ineffective in resolving mental illness when used as an alternative to antipsychotic therapy. However when used as complementary, better outcomes were perceived. Spiritual interventions, herbal therapies, dietary supplements and music therapies were the types of CAM therapies used. Both negative and positive outcomes of CAM therapies were highlighted by caregivers. CAM use may therefore not be an alternative choice but rather complementary to mental health care.

Complementary and alternative medicine for treatment of atopic eczema in children under 14\xa0years old: a systematic review and meta-analysis of randomized controlled trials

BackgroundDue to limitations of conventional medicine for atopic eczema (AE), complementary and alternative medicine (CAM) is widely used as an alternative, maintaining, or simultaneous treatment for AE. We aimed to evaluate the beneficial and harmful effects of CAM for children with AE under 14 years old.MethodsWe searched for randomized trials on CAM in 12 Chinese and English databases from their inception to May 2018. We included children (< 14 years) diagnosed with AE, who received CAM therapy alone or combined with conventional medicine. We extracted data, and used the Cochrane “Risk of bias” tool to assess methodological quality. Effect was presented as relative risk (RR) or mean difference (MD) with 95% confidence interval (CI) using RevMan 5.3.ResultsTwenty-four randomized controlled trials involving 2233 children with AE were included. Methodological quality was of unclear or high risk of bias in general. The trials tested 5 different types of CAM therapies, including probiotics, diet, biofilm, borage oil, and swimming. Compared to placebo, probiotics showed improved effect for the SCORAD index (MD 9.01, 95% CI 7.12–10.90; n = 5). For symptoms and signs such as itching, skin lesions, CAM combined with usual care was more effective for symptom relief ≥95% (RR 1.47, 95% CI 1.30–1.68; n = 8), and for ≥50% symptoms improvement (RR 1.34, 1.25–1.45; n = 9) compared to usual care. There was no statistic significant difference between CAM and usual care on ≥95% improvement or ≥ 50% improvement of symptoms. However, swimming, diet and biofilm showed improvement of clinical symptoms compared with usual care. At follow-up of 8 weeks to 3 years, CAM alone or combined with usual care showed lower relapse rate (RR 0.38, 0.28–0.51, n = 2; RR 0.31, 0.24–0.40, n = 7; respectively) compared to usual care. Twelve out of 24 trials reported no occurrence of severe adverse events.ConclusionsLow evidence demonstrates that some CAM modalities may improve symptoms of childhood AE and reduce relapse rate. Safety remains unclear due to insufficient reporting. Further well-designed randomized trials are needed to confirm the potential beneficial effect and to establish safety use.

Complementary and Alternative Medicine Use Among Overweight and Obese Cancer Survivors in the United States

The purpose of the study was to determine the prevalence of complementary and alternative medicine (CAM) use among US cancer survivors; examine whether use varies by underweight/normal weight, overweight, and obese body mass index status; determine reasons for use; and document disclosure rates of CAM use to medical professionals. Data for 1785 cancer survivors were obtained from the 2007 National Health Interview Survey and CAM supplement. The prevalence and associations of CAM use in the previous 12 months were compared among underweight/normal weight, overweight, and obese adult cancer survivors. Nearly 90% of cancer survivors used at least one type of CAM therapy in the 12 months preceding the survey. Those who were overweight, but not obese, were more likely to use a CAM modality compared to normal/underweight respondents. Over two thirds (71%) reported using CAM therapy for general health and wellness and 39.3% used CAM because a health care provider recommended it. Disclosure rates of CAM use to conventional medical professionals varied widely by CAM modality. An overwhelming majority of US cancer survivors use CAM for a variety of reasons. Overweight cancer survivors may be more likely to use CAM than those who are underweight, normal weight, or obese. Cancer survivors should be screened by medical providers for the use of CAM therapies; furthermore, prospective clinical research evaluating the efficacy and safety of biologically based CAM therapies, often used by cancer survivors, is important and necessary for the well-being of this population.

Knowledge and Attitude of Oncology Practitioners towards Complementary and Alternative Medicine for Cancer Care in Qatar

Objective: The purpose of this study is to investigate the knowledge and attitude of oncology practitioners at NCCCR towards complementary and alternative medicine in cancer treatment. Background: Complementary and alternative medicine (CAM) refers to a set of healthcare practices that are not conventionally used in the country’s hospitals. CAM is widely used by patients who suffer from cancer (from 10%-80%) and authorities call for improving knowledge and experience of oncology practitioners about CAM, so that they can guide their patients about its safe use. Design: Descriptive cross-sectional study. Methods: An anonymous survey of a sample of 75 random practitioners (physicians, nutritionists, psychologists, social workers, pharmacist, physiotherapists, and dieticians excluding nurses) was conducted at the National center for cancer care and research in Doha, Qatar. A semi-structured novel of a 17-item questionnaire was distributed to the staff at NCCCR. The survey collected data regarding benefits, risks, safety, efficacy, and interest in CAM education among NCCCR staff. The Total numbers of questions were 80. Results: Our study showed that 7% of the respondents never heard about CAM. However, 90% of HCP were interested in CAM education opportunities. Herbal medicine was the most familiar type of CAM among HCP (83%), followed by vitamins and minerals (67%), Acupuncture (60%), Massage (57%) and Nutritional Therapy (56%). Some types of CAM therapy were less familiar such as Aromatherapy (28%), Reflexology (27%), Hypnosis (24%) and Art therapies (23%). The majority of HCP thought that CAM therapy improves patient’s psychological and emotional well-being (87%), Quality of life (61%), helps to relieve symptoms of disease (35%) and cure their disease (7%). Concerning safety of CAM usage, 67% of the respondents thought it is safe to use, while 21% thought it is not safe. Conclusion: There is a need of integrating an educational and training program regarding CAM practices and usages in order to enhance cancer patients’ management and ensure a more holistic and efficient cancer treatment for patients in Qatar.

The use of complementary and alternative medicine by individuals with features of metabolic syndrome

To compare the use of complementary and alternative medicine (CAM), including dietary supplements, by individuals with and without features of metabolic syndrome (FeMS). Using a cross sectional study design, information was obtained by self-administered questionnaires from 300 university individuals. FeMS was defined as any individuals self-reporting at least one of the clinical diagnoses of diabetes, hypertension, hyperlipidemia, or obesity. Finally, two categories were created for cross tabulation, and individuals with and without FeMS were compared. Of the 192 individuals completing the study, 39% (n=76) were currently using or had used CAM therapies in the past 12 months. Individuals with FeMS (n=54, 28%) were more likely (P<0.05) to use different types of CAM therapies, in particular dietary and herbal supplements, aromatherapy and massage therapy compared to individuals without FeMS (n=138, 72%). Individuals with FeMS were more likely to use CAM, particularly supplements. Doctors need to properly inquire about and understand their patients' supplement use, especially if CAM therapies are used in conjunction with conventional medications.

Use of Complementary and Alternative Medicine for Eye-related Diseases and Conditions

Aim: To determine the prevalence, types and characteristics associated with complementary and alternative medicine (CAM) use to treat eye-related diseases and conditions.Materials and Methods: The 2002 and 2007 National Health Interview Survey (NHIS) was used to identify participants, 18 years of age and older, who completed the Adult Alternative Health/Complementary and Alternative Medicine questionnaire. Characteristics for those who reported CAM use for eye diseases and conditions and those who did not were compared; the types of CAM and the eye diseases and conditions for their use were also reported.Results: In 2002, an estimated 0.1% of US adults reported using at least one of eight CAM therapies for eye-related problems; in 2007 the prevalence of CAM use for eye diseases and conditions had increased to 0.3%. In both 2002 and 2007, those who reported CAM use for eye diseases and conditions were more likely to be older, female, white and married. In both 2002 and 2007, the most common types of CAM therapies used were natural herbs and vitamin supplements. Macular degeneration was the most common condition for which CAM therapies were used.Conclusions: The study suggests that there is a small and perhaps increasing proportion of the US population that uses CAM for eye diseases and conditions. Further research is needed to determine the use and effectiveness of CAM for ophthalmologic purposes.

Military Report More Complementary and Alternative Medicine Use than Civilians

The study objective was to estimate complementary and alternative medicine (CAM) use among active duty military and compare data with civilian use. A global survey on CAM use in the 12 previous months was conducted. Final participants (16,146) were stratified by gender, service, region, and pay grade. Analysis included prevalence of CAM use, demographic and lifestyle characteristics. Approximately 45% of respondents reported using at least one type of CAM therapy. Most commonly used therapies were as follows: prayer for one's own health (24.4%), massage therapy (14.1%), and relaxation techniques (10.8%). After exclusion of prayer for one's own health, adjusting to the 2000 U.S. census, overall CAM use in the military (44.5%) was higher than that in comparable civilian surveys (36.0% and 38.3%). Military personnel reported using three CAM stress-reduction therapies at 2.5-7 times the rate of civilians. Among the military, high utilization of CAM practices that reduce stress may serve as markers for practitioners assessing an individual's health and well-being.

Prevalence and predictors of complementary and alternative medicine use in African‐Americans with acquired immune deficiency syndrome

BACKGROUND: The use of complementary and alternative medicine (CAM) among Human Immunodeficiency Virus (HIV)-positive individuals is becoming increasingly widespread. Unfortunately, some CAM therapies may jeopardize the efficacy of conventional HIV medication, making it critical to understand CAM use among this population. OBJECTIVE: To investigate the prevalence and predictors of CAM use in a theory-driven, multidimensional manner. METHODS: African-American individuals who had received a diagnosis of acquired immune deficiency syndrome (AIDS) were recruited. The computer-administered survey asked questions about participants' CAM use and various psychosocial and socio-demographic characteristics. Participants' most recent CD4+ cell counts and HIV RNA levels were abstracted from medical records. Linear regression analyses, adjusted for potential confounders, were conducted to assess the independent contribution of various factors in explaining frequency of CAM use. RESULTS: One hundred and eighty two subjects participated in the survey. Results indicate that most (94%) participants used at least one type of CAM therapy. The majority of participants (79.7%) used CAM therapies as a complement (rather than an alternative) to their HIV medications though half had not discussed these therapies with their healthcare providers. Female sex, high yearly income, high health literacy and high HIV RNA levels were associated with a greater frequency of CAM use, while stronger emotional well-being was associated with a lower frequency of CAM use. CONCLUSIONS: The implications of these findings are discussed and suggestions for future research are provided.

Patterns and perception of complementary and alternative medicine use by patients in western Nepal

This study aims to investigate the patterns of complementary and alternative medicine (CAM) use and perception of CAM use amongst patients attending CAM clinics in Pokhara Sub-Metropolitan City (PSMC), western Nepal. A cross-sectional survey was carried out on 501 proportionally selected patients attending 52 CAM clinics in PSMC. Data were collected using semi-structured questionnaires consisting of 16 questions related to demographic and socioeconomic characteristics, indications, and patient’s perception of CAM use. Descriptive statistics were used for data analysis. The patients with a higher education level, higher income, and aged above 40 years were found more likely to use CAM. Belief in the advantages of CAM therapy (n = 308, 61.5%) was the most commonly perceived reason for using CAM. CAM therapies were mainly adopted for gastrointestinal problems (n = 107, 21.4%) and paralysis (n = 89, 17.8%). Most of the patients (n = 382, 76.3%) had tried allopathic treatment prior to using CAM therapy for the same indication. A total of 279 patients (55.69%) were using more than 1 type of CAM therapy where the most commonly used therapies were Ayurveda (n = 384, 76.7%) and yoga (n = 141, 28.1%). The majority of the patients (n = 425, 84.8%) reported that they would advise others to use CAM therapy. Use of CAM is more common among patients with chronic conditions especially gastrointestinal disorders and paralysis for which they had already tried allopathic medicine. The majority of the patients viewed CAM as beneficial, cheaper, and free of side effects. However, studies on safety and efficacy of these CAM therapies are promptly needed in this region.

Complementary and alternative medicine (CAM) use among cancer patients in community oncology settings.

e19544 Background: Previous surveys of CAM use in oncology have primarily been conducted at comprehensive cancer centers and other major medical centers. The prevalence and attitudes towards CAM in community oncology settings is unknown. Methods: We are conducting an educational intervention within the M. D. Anderson CCOP network to encourage oncology nurses to discuss CAM use with their patients. Here we provide baseline data on the frequency of and reasons for CAM use and how often CAM was discussed with oncology health care practitioners. Participants included 566 cancer patients from 36 CCOP component sites. Questionnaires were completed immediately following the patient's oncology visit. Results: Patients were 65% female, 86% non-Hispanic white, average age of 59 (range 23-88), and 30% had a college degree or higher. The most common cancers were breast cancer (31%), lung cancer (12%), and colorectal cancer (10%). Time since initial cancer diagnosis was 1.96 years and 28% had a cancer recurrence. Thirty-nine percent indicated that they have used one or more CAM therapies following their cancer diagnosis. Reasons for using CAM included: believes CAM beneficial (27%), to address the emotional and spiritual aspects of the disease (23%), and to boost immune system (21%). The most common categories of CAM used by patients were massage therapy (19%), relaxation techniques (19%), special diet (18%) and megavitamins (15%). Patients indicated that 9% of their physicians and 12% of nurses had asked them about their use of CAM at that oncology visit. Twenty-one percent of patients reported that they initiated a discussion with their providers about their use of CAM and the most common responses were: encouraged me to continue (13%) and was neutral (7%). Reasons for not telling health care practitioners about CAM use included: my health care provider never asked (27%) and unsure if CAM beneficial (18%). Conclusions: More than one-third of patients indicated that they used some type of CAM therapy and the majority of their providers did not ask them about their CAM use. There remains considerable uncertainty among patients about the role of CAM in the context of cancer care. No significant financial relationships to disclose.

Patterns of the Use of Complementary and Alternative Medicine in Women With Metastatic Cancer

Complementary and alternative medicine (CAM) has been widely used in the general population and in patients with cancer. Female sex and advanced cancer are 2 reported factors contributing to CAM use. The aim of this study was to examine the patterns of CAM use among women with metastatic cancer. A total of 68 women were enrolled into this cross-sectional study. All participants were receiving conventional treatment in a single inpatient oncology center. Data were collected from the women through a face-to-face interview guided by a questionnaire. On the basis of women's responses, all participants were divided into 2 groups: CAM users and nonusers. The 2 cancers most frequently diagnosed in these women were gastrointestinal cancer (36.8%) and breast cancer (33.8%). Of 68 women, 40 (58.8%) reported the use of at least 1 type of CAM therapy after the diagnosis of cancer. There were no significant differences in the sociodemographic and clinical characteristics between CAM users and nonusers (P > .05). The most frequently used CAM method was herbal therapy (34.6%) and the second was nutritional supplements (17.9%). A considerable proportion (60.0%) of CAM users had not discussed their CAM use with their physicians or nurses. Four (10%) patients reported an adverse effect due to CAM use. Our findings indicate that Turkish women with metastatic cancer seek to use CAM, with a small minority being at risk of potential adverse effects of certain CAM products. Because of the high prevalence of CAM therapies among women with metastatic cancer, oncology specialists and nurses should increase their knowledge about CAM therapies. Nurses are in a position to provide knowledge and education about CAM therapies and to develop protocols and guidelines about CAM use for patients with cancer.

Complementary and Alternative Medicine Therapies for Diabetes: A Clinical Review

C omplementary and alternative medicine (CAM) refers to a wide range of clinical therapies outside of conventional medicine.1 The term “complementary” refers to therapies that are used in conjunction with conventional medicine, whereas “alternative” medicine includes therapies that are used in place of conventional medicine. The term “integrative” medicine has been advocated by some CAM providers and researchers as representing a combination of conventional medicine, CAM, and evidence-based medicine.2 The National Center for Complementary and Alternative Medicine, a federal scientific agency for CAM research, categorizes CAM into five domains: biologically based practices, mind-body medicine, manipulation and body-based practices, energy medicine, and whole-medical systems (Table 1). Biologically based practices and mind-body medicine are the most common CAM modalities used and studied for the treatment of diabetes in the West and are the focus of this review. In the United States, CAM is frequently used by adults, with 40% reporting use in the past 12 months.3 An estimated 34% of adults with diabetes use some type of CAM therapy.4 The estimated out-of-pocket expense in 2007 on CAM therapies was $44 billion.5 Although some CAM therapies have been shown to affect glycemic control, the clinical efficacy and mechanism of many CAM therapies for diabetes is controversial, and safety issues are a concern. Adverse effects of many CAM therapies are not well documented. Because patients with diabetes often take multiple prescription medications, there exists the potential for herb-drug and herb-dietary supplement interactions, leading to adverse events.6,7 At least 63% of the general population do not disclose use of CAM therapies to their physicians.8 The purpose of this clinical review is to discuss selected CAM therapies frequently used for patients with diabetes and to provide a framework to advise patients on CAM use. INBRIEF More than …

Use of Complementary Medicine in Pediatric Patients With Inflammatory Bowel Disease: Results From a Multicenter Survey

We examined the use of complementary and alternative medicine (CAM) at 3 US pediatric medical centers, comparing a group of children with inflammatory bowel disease (IBD) with children presenting with chronic constipation. Surveys were administered by postal mail and at pediatric IBD centers in San Francisco, Houston, and Atlanta from 2001 to 2003. A comparison group consisting of pediatric patients with chronic constipation also was surveyed. Data were analyzed by t tests and by exact tests of contingency tables. In all, 236 surveys were collected from the IBD group; 126 surveys were collected from the chronic constipation comparison group. CAM therapies were used by 50% in the IBD group and 23% in the chronic constipation group. The overall regional breakdown of CAM use in IBD revealed no differences, although the types of CAM therapy used varied by site. The most commonly used CAM therapies in the IBD group were spiritual interventions (25%) and nutritional supplements (25%). Positive predictors for CAM use in IBD include the patient's self-reported overall health, an increase in the number of side effects associated with allopathic medications, white ethnicity, and parental education beyond high school. This is the first US study to characterize CAM use in pediatric patients with IBD with another chronic gastrointestinal disorder. CAM use was twice as common with the IBD group compared with the chronic constipation group. Regional variations exist with the types of CAM therapy used. Practitioners should know that half of their pediatric patients with IBD may be using CAM in conjunction with or as an alternative to other treatments and that certain predictors can help identify those using CAM therapies.

A study on the utilization of complementary and alternative medicine for elementary children

Purpose : Recently, complementary and alternative medicine (CAM) has been increasingly used in children. Studies have shown that 34% of adults and 11% of children use CAM in the USA and Canada. The purpose of this study was to investigate the prevalence and patterns of CAM use in elementary children in Korea. Methods : From July to August 2007, parents of elementary children completed a questionnaire survey at Gwang-ju. In all, 794 questionnaires were analyzed. Results : Of the 794 respondents, 278 answered that their pupils (35%) had experienced CAM. The following types of CAM therapy were used: herbal medicine, 62.5% dietary supplements, 31.2% vitamins, 30.2% and acupuncture, 11.1%. CAM therapies were used for the following diseases: nutritional deficiency, 33.3% atopic dermatitis, 31.3% arthralgia, 31.3% allergic rhinitis, 28.8% obesity, 26.3% and asthma. The following were the motives to use CAM: prevention of diseases (33.5%), dissatisfaction with modern medicine (21.2%), and complementary therapy to modern medicine (20.5 %). People gained information about CAM through neighbors (65%) and mass media (21%). Moreover, 83 parents (30 %) were satisfied with CAM because of its effectiveness. Conclusion : Many parents have advocated the use of CAM in their children. However, most of them used CAM without any prescription or adequate knowledge. Further studies are required to determine the efficacy of CAM. (Korean J Pediatr

The successful resolution of chronic constipation in three pediatric patients following chiropractic spinal manipulative therapy

Chronic constipation is a common condition in the very young and the very old. This is reflected in approximately $800 million spent on laxatives in the United States each year. The elimination of food waste from the body is a common and simple daily occurrence for most individuals. Constipation is such a common problem in the pediatric population that it is the second most referred problem to the pediatric gastroenterologist and accounts for 25% of all visits. Between 5% and 28% of all children experience great difficulty with elimination of food waste, which is often accompanied with pain, fear, and avoidance. The symptoms of constipation are defined as infrequent or difficult evacuation of the feces. The ever-increasing use of complementary and alternative medicine (CAM) in adults is also reflected in CAM use by children. In fact, adult CAM users are three times as likely to use CAM for their children compared to non-CAM users. Chiropractic stands as the most popular type of CAM therapy for children. Given the many anecdotes and testimonials within the chiropractic profession on the successful care of pediatric patients with various pediatric conditions, we describe through a case series presentation the successful outcome of chiropractic care in pediatric patients with chronic constipation. All three patients were under the age of 2 years with bowel movements ranging from once per week to every 3–4 days. Previous unsuccessful care involved medical advice with dietary changes and the use of cod liver or mineral oil. Following a trial of chiropractic care using a combination of high-velocity, low-amplitude thrusts and a manually assisted, hand-held instrument to sites of spinal segmental dysfunction, the patients’ constipation resolved as demonstrated by an increased frequency in bowel movements at once to every 1–2 days with accompanying soft stool without straining and pain.

The Status of Complementary and Alternative Medicine Education in U.S. Physician Assistant Programs

Background: Many Americans use complementary and alternative medicine (CAM). Medical educators have responded by incorporating CAM education into their curricula. Research has reported on the number and types of CAM therapies included in physician assistant (PA) curricula, but information on the purposes, methods, and practice of CAM education is lacking. Purpose: This study was designed to identify the content, methods, purpose, and orientation to CAM education in PA curricula. Methods: An online survey of all accredited physician assistant programs in the United States addressing content, teaching methods, instructor qualifications, and core competencies was administered. Results: Response rate was 68%: 77% of PA programs included CAM education in their curriculum; 93% stated it was required. The median number of CAM therapies included in the curriculum was 10. Reasons for including CAM were increased use by patients (79%), complementary medicine in the medical literature (66%), and faculty interest or request (62%). For most PA programs, CAM is taught as a component of other courses through lectures and written exams. Core competencies are consistent with recommendations of the PA profession, as well as other professional medical associations. Conclusions: Most PA programs have incorporated CAM instruction into their curricula. Content is typically limited to those CAM therapies most commonly encountered in medical practice. The means and methods of teaching CAM are largely the same as for traditional medical content. The most common objectives of CAM education are learning to assess for CAM use, educating patients, and recognizing indications and contraindications while respecting patients' health beliefs and choices.