Use Of Complementary Therapies Research Articles

Use of complementary therapies and supportive measures of patients with intracranial gliomas-a prospective evaluation in an outpatient clinic.

Patients with intracranial gliomas frequently seek for complementary and alternative medicine (CAM), in addition to guideline-directed therapy. In this study, we therefore assessed patients' information needs regarding treatment and support, and evaluated their attitudes toward experimental trials and alternative therapies. A prospective, cross-sectional, descriptive survey was conducted in our center. We developed an interview focusing on how patients obtain further information about therapy and the use of alternative/complementary therapies. A total of 102 patients participated in the survey. 50% (n = 51) of patients reported that they had not attempted any additional therapies. When patients attempted self-therapy, it was most commonly in the areas of nutrition (25%, n = 26) and dietary supplements (17%, n = 17). Alternative or complementary therapies were used by 14% (n = 14) of the patients. Younger age (Odds ratio (OR) 0.96 (95% Confidence interval (CI) 0.92-0.99, p = 0.012) and tumor entity (OR 5.01 (95% CI 1.66-15.11, p = 0.004) for grade 4 vs. 3 tumors and OR 7.22 (95% CI 1.99-26.28) for grade 4 vs. other tumors p = 0.003) were significantly associated with a greater interest in CAM. Interest in complementary and alternative medicine, as well as nutrition and dietary supplements is high (51%) among glioma patients, and significantly higher among younger patients and those with a worse diagnosis (WHO grade 4). A comprehensive approach to information, including paramedical topics, is needed to provide optimal patient counseling and care for glioma patients.

Haemodialysis Patients' Experiences on Complementary and Alternative Therapies: A Qualitative Study

Background: The term complementary and alternative therapies refers to a broad range of medical and healthcare procedures that are outside the purview of traditional medicine. Despite gaps in the scientific evidence to support its use and difficulties in regulating and integrating it into traditional healthcare procedures, the use of complementary and alternative therapies is constantly rising. Aim: This study aims to explore the experiences of complementary and alternative therapies among haemodialysis patients. Material and Methods: The study was carried out by adopting the qualitative descriptive research method. Semistructured qualitative interviews, with 17 haemodialysis patients, were analyzed with qualitative content analysis. Data saturation was reached during interviews, and audio recordings were verbatim transcribed. Both researchers independently identified key topics, which were subsequently discussed and evaluated simultaneously. Results: We identified 4 overarching main themes in this setting: (1) Seeking Control over Health (to have control over their health status); (2) Relief from negative symptoms (to get rid of the negative symptoms they experience; (3) Hope (in the hope of feeling healthy again); and (4) Fear (in which they are afraid to tell health professionals and are afraid of not receiving support). Conclusion: This study showed that haemodialysis patients seek complementary and alternative therapies because of having control over their health, relief from negative symptoms, hope to feel healthy again, and fear of telling health professionals and receiving support. It is recommended that health professionals should provide information about the safety and possible side effects of these therapies and practice patient-centered treatment through active communication during the treatment process.

Antioxidant Properties of Resveratrol in the Brain Tissues of Rats after Radiotherapy

Background:: In recent years, there has been growing interest in the use of herbal products as complementary or alternative therapies for cancer patients. RVT has been extensively studied for its potential role in managing oxidative stress in cancer patients undergoing treatment. Method:: In this study, the radioprotective effects of Resveratrol (RVT) (200 mg/kg) were evaluated in the brain tissues of rats after Radiation Therapy (RT). 20 male adult Wistar rats weighing 180–200 g were used. The animals were exposed to single-fraction Irradiation (IR) (15 Gy) using a linear accelerator unit (Siemens Primus) at a dosage rate of 200 cGy/min at a distance of 100 cm from the source to the axis. Results:: The results of the study showed that compared to the IR group, administration of RVT decreased the levels of MDA and NOx, and increased the levels of CAT and SOD significantly (p<0.05). Conclusion:: Finally, our finding suggests that RVT could have radioprotective effects on the brain by enhancing antioxidant defense mechanisms.

Examination of Complementary Treatment Use of Individuals with Interstitial Cystitis: Descriptive Study

Objective: The aim of this study was to examine the use of complementary therapy in individuals with interstitial cystitis. Material and Methods: This study, which was carried out in a descriptive research design, was carried out with 80 female patients over 18 years of age with interstitial cystitis, who applied to the Urology Outpatient Clinic of a city hospital in Istanbul between January and July 2023. The data were collected by face-to-face (onsite) interview method using a form prepared by the researchers in line with the literature to determine the socio-demographic characteristics of the patients and their use of complementary therapy. Data were analyzed using SPSS 22 statistical software for Windows. Results are reported as mean ± SD. Ethics committee and institutional permission were obtained before starting the study. Results: When the characteristics of the individuals included in the study were examined; The mean age was 42.80±10.68 years, 60% did not have a chronic disease, 65% used any complementary treatment method, 43.2% used herbal treatment method, 50% did not receive complementary treatment. 55% received this information from the physician, 50% used complementary therapy to reduce their pain, 61.5% did not experience any side effects after using complementary therapy, 80.8% believed that complementary therapy was effective. It was determined that 53.8% of them did not share the complementary treatment methods they used with the physician or nurse. Conclusion: It was seen that the majority of individuals with interstitial cystitis used any complementary treatment, half of them did not get information before using the treatment, and more than half did not share the complementary treatment methods they used with the physician or nurse.

Relationship between coronavirus anxiety, resilience, and attitudes toward complementary and alternative treatment among patients admitted<br /> to the COVID-19 Outpatient Clinic

<b>Aim</b>: During the COVID-19 pandemic, the studies showed an increase in complementary and alternative therapy use. This study aimed to determine the relationship between coronavirus anxiety, resilience, and attitudes toward complementary and alternative treatment among patients admitted to the COVID-19 outpatient clinic.<br /> <b>Material and methods</b>: This is a descriptive and relational study. The sample consisted of 364 patients who applied to the pandemic outpatient clinic of a training and research hospital in Turkey. Data were collected using the Coronavirus Anxiety Scale, Brief Resilience Scale, and Scale for Attitudes toward Complementary and Alternative Medicine. The Mann–Whitney U test, the Kruskal–Wallis test, and the Spearman correlation test were used in data analysis.<br /> <b>Results</b>: There was a moderate and negative correlation (r = −0.332) between attitudes toward complementary and alternative medicine and coronavirus anxiety, and a moderate and positive correlation (r = 0.348) between attitudes toward complementary and alternative medicine and resilience (p < 0.01). Additionally, there was a moderate and negative correlation between coronavirus anxiety and resilience (r = −0.667; p < 0.01).<br /> <b>Conclusion</b>: In the COVID-19 pandemic process, it is essential to follow up on patients' complementary and alternative medicine use, inform them, and determine their causes.

Knowledge and Attitudes Towards Use of Complementary and Integrative Health Therapies for Veterans with Opioid Use Disorder in the Veterans Health Administration

The Veterans Health Administration (VA) offers complementary and integrative health (CIH) therapies to Veterans with chronic pain and opioid use disorder (OUD). While CIH therapies have known benefits for chronic pain, less research exists on its use for patients with OUD. In this qualitative study, we aimed to assess provider and patient perceptions of CIH therapies for Veterans with OUD. We interviewed 45 providers involved in OUD care and 17 Veterans with OUD from five VA medical centers as part of a larger mixed-methods evaluation. Interviewees were identified through a snowball sampling strategy. The interview guide used the Practical Robust Implementation and Sustainability Model to explore contextual factors influencing CIH therapy adoption (i.e., patient perspectives, provider perspectives, external environment). Most Veterans and providers were knowledgeable about CIH therapies and had positive experiences with them. Providers and Veterans said it was important to offer non-pharmacologic options for OUD. Some providers, however, felt that Veterans with OUD may be less likely than those with only chronic pain to consider CIH therapies due to more reported patient resistance and other barriers. Veterans with OUD and their providers were enthusiastic about integrating CIH therapies into treatment plans as a non-pharmacologic option for chronic pain and OUD. However, providers noted unique challenges impacting use of CIH therapies for Veterans with OUD. Providers may benefit from learning patient-centered approaches to offering CIH therapies to Veterans with OUD as part of a comprehensive pain treatment plan.

Is there an Association between Complementary and Alternative Medicine use and Trust in Physicians in Patients with Rheumatic Diseases?

Generally, patients with chronic rheumatic diseases use complementary and alternative medicine (CAM) in addition to their conventional treatments to manage their health. Discussing these treatments with their physician is still rare, which might be directly related to patients' trust toward them. The primary objective of this study was to assess the association between patients' trust in their physician and the use of complementary and alternative medicine among patients with chronic inflammatory rheumatic diseases. As secondary objectives, to estimate the prevalence of CAM use, and to identify the associated factors with their use and with trust in physicians. This is a cross-sectional study, which included patients with established chronic inflammatory rheumatic diseases, at the University Hospital Center in Tangier. The questionnaire included demographic and clinical information, use of conventional therapy, complementary and alternative therapy, as well as interpersonal trust in patient-physician relationships using the Trust in Physician Scale (TPS). A regression analysis was conducted to identify factors associated with CAM use and with trust in physicians. The study included 189 patients. 57.14% of patients reported using complementary medicine at least once, most patients were women (77.78%), mean age was 46.67 ± 13.25 years with an average course of the disease of 11.11 ± 9.23 years. The most frequently used CAM treatments were cupping therapy, massage and the ingestion of a mixture of plants. Mean ± SD Trust in Physician Scale was 47.64 ± 7.2. There was no significant difference between CAM users vs. non-users (48.08 ± 6.9 vs 47.04 ± 7.4; p = 0.35). In uni and multivariate analysis, a low level of education was significantly associated with the use of CAM. However, no statistically significant difference was found with trust in physicians (OR = 1.020, 95% CI (0.978-1.063), p = 0.354). CAM therapy is common in patients with chronic inflammatory rheumatic diseases. No statistically significant association was found with trust in physicians, it was rather observed with level of education.

Measuring Patient-Reported Use and Outcomes From Complementary and Integrative Health Therapies: Development of the Complementary and Integrative Health Therapy Patient Experience Survey.

Assessing the use and effectiveness of complementary and integrative health (CIH) therapies via survey can be complicated given CIH therapies are used in various locations and formats, the dosing required to have an effect is unclear, the potential health and well-being outcomes are many, and describing CIH therapies can be challenging. Few surveys assessing CIH therapy use and effectiveness exist, and none sufficiently reflect these complexities. In a large-scale Veterans Health Administration (VA) quality improvement effort, we developed the "Complementary and Integrative Health Therapy Patient Experience Survey", a longitudinal, electronic patient self-administered survey to comprehensively assess CIH therapy use and outcomes. We obtained guidance from the literature, subject matter experts, and Veteran patients who used CIH therapies in designing the survey. As a validity check, we completed cognitive testing and interviews with those patients. We conducted the survey (March 2021-April 2023), inviting 15,608 Veterans with chronic musculoskeletal pain with a recent CIH appointment or referral identified in VA electronic medical records (EMR) to participate. As a second validity check, we compared VA EMR data and patient self-reports of CIH therapy utilization a month after survey initiation and again at survey conclusion. The 64-item, electronic survey assesses CIH dosing (amount and timing), delivery format and location, provider location, and payor. It also assesses 7 patient-reported outcomes (pain, global mental health, global physical health, depression, quality of life, stress, and meaning/purpose in life), and 3 potential mediators (perceived health competency, healthcare engagement, and self-efficacy for managing diseases). The survey took 17minutes on average to complete and had a baseline response rate of 45.3%. We found high degrees of concordance between self-reported and EMR data for all therapies except meditation. Validly assessing patient-reported CIH therapy use and outcomes is complex, but possible.

Complementary Therapies and Their Association with Problems in Therapeutic Adherence to Conventional Synthetic DMARDs in Rheumatoid Arthritis: A Cross-Sectional Study.

The use of complementary therapies is highly prevalent among patients with rheumatoid arthritis (RA). Nevertheless, the use of complementary medicine could involve problems in the following of scientifically accepted treatments. To date, there is limited information regarding the association of nonconventional therapies with problems regarding compliance with the treatment. Therefore, the objective of this study was to identify whether the utilization of complementary therapies is associated with a high risk of problems regarding therapeutic adherence to conventional synthetic disease-modifying anti-rheumatic drugs (cs-DMARDs) in RA patients. A survey was performed with RA patients in an outpatient rheumatology clinic in a university hospital; the use of complementary therapies, as well as their type, was identified. To assess problems with therapeutic adherence, we used the four-item Morisky-Green scale. A comprehensive assessment of clinical and therapeutic characteristics was performed. Univariable and multivariable models were performed to identify the risk of problems with therapeutic adherence in users of complementary therapies. In total, 250 RA patients were included; 92% used complementary therapies. Of them, the most frequently used were herbal medicine (65%), homeopathy (64%), and cannabis and its derivatives (51%). In the univariable logistic regression analysis, the factors associated with problems in the therapeutic adherence to cs-DMARDs were age (p = 0.019), the presence of other comorbidities (p = 0.047), and the use of complementary therapies (p = 0.042). After controlling for potential confounders, the use of complementary therapies increased the risk of problems with therapeutic adherence to cs-DMARDs (adjusted OR = 2.84, 95% CI = 1.06-7.63, p = 0.037). We concluded that the use of complementary therapies increases the risk of problems with therapeutic adherence. Therefore, for physicians and healthcare professionals, the early identification of the use of nonconventional therapies in their RA patients is required, followed by a directed discussion with their patients about the risks and benefits to which they could be exposed to complementary therapies.

A comparative analysis of complementary therapies use among patients attending diabetic clinics in Taiwan: 2007 vs. 2023

BackgroundWe conducted a comparative study to examine the differences in the use of complementary therapies (CT) among patients who attended diabetic clinics for follow-up treatment between 2007 and 2023 in Taiwan.MethodsThis study employed a cross-sectional survey design to recruit individuals with diabetes from two regions (northern and southern) of Taiwan. A total of 183 and 307 participants were included in the surveys of 2007 and 2023, respectively. The data were analyzed using IBM SPSS Statistics version 28.0 to compare the survey results between the two time periods.ResultsAmong the various CTs, nutritional supplements remained the most prevalent, with a significant increase in usage from 68.3% in 2007 to 89.9% in 2023. Conversely, other therapies, such as Chinese herbal medicines, manipulative-based therapies, supernatural healings, and bioelectromagnetic-based therapies, demonstrated a significant decrease in usage between the two time periods. Furthermore, the disclosure rate of CT use to healthcare professionals remained persistently low, with only 24.6% in 2007 and a slight increase to 30.3% in 2023.ConclusionThe significant rise in the use of nutritional supplements in conjunction with conventional medicine, without adequate monitoring and guidance from healthcare professionals, poses a substantial risk of unregulated blood sugar control, compromised diabetes management, and potential harm to health outcomes.

[Storing Complementary Therapy Knowledge to Expand Nursing Roles].

Incorporating complementary therapy into nursing care is common in clinical practice. Complementary therapy is a non-pharmacological approach used to help address symptoms that cannot be alleviated entirely by medication. These complementary therapies often serve specific purposes, and nurses are the ideal candidates to administer them due to their patient care expertise. However, before applying any complementary therapy, it is essential to understand the potential medical safety, ethical, and legal considerations involved in the therapeutic process. Furthermore, administrators should strengthen their knowledge and implementation of these therapies to ensure safety during use. Complementary therapy facilitates the management of symptoms that are not manageable by medication alone. For example, aromatherapy and light therapy are employed in clinical settings to alleviate anxiety, depression, insomnia, and pain (Farrar & Farrar, 2020; Fong et al., 2023), while acupuncture, acupressure, and qigong are utilized to relieve pain in cancer patients (Behzadmehr et al., 2020). Although complementary therapy is gradually gaining acceptance in clinical practice for mitigating patient discomfort, it has yet to achieve widespread adoption, with the culture within healthcare institutions and the attitudes of healthcare professionals being significant factors influencing adoption willingness. Research findings indicate that the primary factor influencing the use of complementary therapy by nurses is lack of relevant knowledge (Siedlecki, 2021). Elements of complementary therapy have been incorporated into the blueprint of the National Council Licensure Examination - Registered Nurse in Western countries. Thus, nursing education programs in the United States are now required to integrate complementary therapy into their curricula (Helms, 2006). The above emphasizes the importance of equipping nursing professionals with crucial knowledge and skills related to complementary therapy. When integrated appropriately and safely into patient care, complementary therapy not only enhances the quality and status of nursing but also demonstrates the irreplaceable role of nurses in assisting patients manage symptoms that are not fully manageable by medication alone. As modern medical technology and treatment modalities continue to grow in complexity, nursing professionals must maintain an open-minded perspective and be willing to adapt to and learn the diverse knowledge and skills required in today's era of interdisciplinary. Implementing complementary therapy requires relevant healthcare knowledge for symptom relief as well as familiarity with the related principles and skills. Complementary therapy often involves more extended contact with the recipients of care, making it safer and more appropriate when administered by nursing professionals who have received medical training. In this column, three articles discuss common complementary therapeutic practices such as aromatherapy, the non-invasive Chinese medicine meridian-and-acupoint intervention, and light therapy. Each article introduces the principles of these therapies and their application in nursing. It is hoped that the information provided on these three complementary therapies will help nursing professionals find reference points for expanding and strengthening their interdisciplinary nursing practices. Thus, the inherent advantages of the nursing profession may be leveraged to further enhance and implement the professional nursing process and to maximize the roles and capabilities of the nursing profession.

Evaluation of thirst severity, death anxiety, and complementary and supportive therapy use as predictors of urinary incontinence-related quality of life in older adults.

This correlational survey study aimed to evaluate thirst severity, death anxiety, and the use of complementary and supportive therapy as predictors of urinary incontinence-related quality of life in older adults. The study included 368 participants aged 60 or older. Data were collected by face-to-face interviews using a participant information form, the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), Visual Analog Scale for thirst severity, Death Anxiety Scale, a modified version of the Mini Mental State Examination, and questions about their use of complementary and supportive therapies. The participants had a mean age of 70.5 ± 6.9years (54.9% female). Mean ICIQ-SF score was significantly correlated with daytime frequency of urine leakage and thirst severity score. Multiple linear regression analysis indicated that thirst severity was a significant predictor of urinary incontinence-related quality of life. Most of the older adults said they had never used complementary or supportive therapies for urinary incontinence. Thirst severity should be assessed in older adults with urinary incontinence in addition to other factors that may affect ICIQ-SF scores.

The foundations of Homeopathy and its use in the SUS: An integrative review

Introduction: The objective of this study is to evaluate the use of Homeopathy in the SUS, analyzing the existing prejudices and contrasting them with scientific results, using a literature review. Methodology: A narrative literature review was carried out and the search for articles occurred through the use of the descriptors inserted in the MeSH: "Homeopathy" and "Unified Health System". The Boolean operator "AND" was used between the combinations. The inclusion criteria were articles related to the selected descriptors, with English and Portuguese language and between 2007-2022. We found 8 articles in Scielo and 17 in pubmed, totaling 25 articles. Results: Homeopathy is a medicinal treatment and secular practice. However, despite being regulated by the SUS, homeopathic therapy is not widespread in Brazil, since there are difficulties in the development of research in the area, either due to methodological difficulties or financial support. Discussion: The low use of Complementary Therapies in the SUS may be associated with the lack of knowledge about such practices by health professionals, who in turn are unaware of the existence of the PNPIC, as well as the lack of disciplines that address this theme in undergraduate courses. Even though it is a practice used for more than two centuries in several countries, Homeopathy remains marginalized in the face of modern scientific rationality because it is based on unorthodox principles, which challenge the linear thinking characteristic of the paradigm of traditional science, which presupposes objectivity, stability and simplicity. Conclusion: Humanizing patient care, adopting preventive practices to cope with diseases, building a healthy life, recovering the understanding of the health-disease concept, are the principles that guide SUS policies and that meet the fundamentals of Homeopathy. In addition, its inclusion in the SUS makes it possible to expand the universe of users, configuring the citizen's right to choose. This work suggests more in-depth research on the subject and improvements in communication between health professionals.

Nutraceuticals and biotics in pediatric gastrointestinal disorders.

In recent years there has been growing interest in the use of nutraceuticals and biotics in both pediatric and adult clinical practice. The overlapping and often ambiguous symptoms of both functional and organic gastrointestinal disorders have led to a search for alternative therapeutic approaches that avoid the use of synthetic or chemical treatments. However, while nutraceuticals and natural supplements are widely used, their health benefits are often not supported by adequate scientific evidence, and an unregulated use of nutraceuticals can be potentially harmful. The correct use of nutraceuticals, prebiotics, and probiotics can optimize the results of drug therapy in some cases and reduce the risk of side effects. This review aims to provide clinicians with guidance on the use of complementary therapies for pediatric gastrointestinal symptoms and disorders, highlighting the scarcity of studies on the kinetics and dynamics of nutraceuticals and biotics. While it is generally difficult to associate their intakes with adverse events due to the often-coexisting pharmacological treatments, it is essential to avoid the abandonment of traditional drugs with proven efficacy in the treatment of single diseases. Overall, the use of nutraceuticals, prebiotics, and probiotics in pediatric gastroenterological practice requires caution and medical supervision. Further research is needed to determine the effects of alternative therapies on pediatric gastrointestinal symptoms and disorders, and to ensure their safe and effective use in the clinical practice.

Sexuality in Women with Fibromyalgia Syndrome: A Metasynthesis of Qualitative Studies.

Metasynthesis of qualitative studies. The search included articles published between 2000 and June 2023 on the PubMed, WOS, CINAHL, SCOPUS, and SCIELO databases. 450 articles were found through the initial search, of which, only nine fulfilled the criteria and were included in the thematic synthesis. From this analysis, three main themes emerged: (1) "I want to, but I can't": FMS causes a shift in feminine sexuality. (2) Resetting sex life and intimacy. (3) Taking charge of a "new sexuality." Women with FMS suffer from limitations of their sexuality that affect their partner. Pain, stiffness and a loss of desire make sexual encounters difficult. Becoming aware of this and striving not to lose their sexuality is key to coping with this problem. Women and their sexual partners can change roles and encourage communication, games, foreplay or touching. The use of lubricants, physical exercise and complementary therapies, along with social, professional and partner support, are key to coping with FMS.

Frequency and satisfaction of conventional and complementary or alternative therapies for neuromuscular disorders

BackgroundCausal therapies are not yet available for most neuromuscular diseases. Additionally, data on the use of complementary or alternative therapies (CAM) in patients groups with a variety of different neuromuscular diseases are rare. This retrospective cross-sectional study aims to record the frequency of use and satisfaction of conventional therapies and complementary or alternative medicine (CAM) in patients with neuromuscular disorders in order to compare them afterwards.MethodsPatients from the University of Leipzig (Department and Outpatient Department of Neurology), the Friedrich-Baur-Institute (Department of Neurology), the Hoher Meißner Clinic (Department of Neurology) and the German Society for Muscular Diseases (DGM e.V.) were included. The focus of this study has been on patients with chronic neuromuscular diseases. Our data are based on standardised questionnaires in analogue form from three German neuromuscular centres and in digital form from the official website of the German Society for Muscular Diseases. Therapy satisfaction was assessed with the Patient Evaluation of Global Response (PEGR) ranking scale (very satisfactory + 2 to very unsatisfactory − 2).ResultsOf 192 questionnaires analysed, the most common diagnoses were spinal muscular atrophy (n = 42; 21.9%), muscular dystrophies (n = 41; 21.4%) and myotonic dystrophies (n = 38; 19.8%). More than half (n = 112; 58.3%) used both conventional and CAM treatments. Physiotherapy (n = 165) was used most frequently within all treatments with conventional manual (PEGR 1.25, p = 0.013; CI 95%) and aquatic therapy (PEGR 1.3, p = 0.038) showing significantly higher satisfaction compared to therapy on training equipment. Less-used therapies such as psychotherapy (n = 53; PEGR 1.2) were also satisfactory. Within CAM, massages (n = 96) were the most reported and meditation (PEGR 1.5) was best rated. Massage therapy was significantly more satisfactory than progressive muscle relaxation (p = 0.003) and chiropractic treatment (p = 0.036). Chiropractic treatment (PEGR − 0.1) was rated most negatively. No significant differences were found between the group of conventional therapies and CAM users regarding social and disease-dependent factors.ConclusionsTreatment with conventional therapy (manual, aquatic therapy) and some CAM therapies can be recommended if adequately indicated.

Factors contributing to flares of ulcerative colitis in North India- a case-control study

BackgroundUlcerative colitis is a relapsing and remitting disease that may be associated with flares. The causes of flares in the Indian setting are not well recognized.MethodsThe present prospective case-control study was conducted at a single center in North India. Cases were defined as patients admitted for flare of ulcerative colitis, while controls were patients in remission enrolled from the outpatient department. The basis of the diagnosis of flare was a simple clinical colitis activity index (SCCAI) of ≥ 5 and endoscopic activity, while remission was based on SCCAI < 4 and a normal fecal calprotectin. A questionnaire evaluating recent infections, stress, drug intake (antibiotics, pain medication), adherence to therapy, and use of complementary and alternative therapy (CAM) was administered.ResultsWe included 84 patients (51 with flare and 33 in remission) with a median age of 38 years, of whom 47 (55.9%) were males. The two groups were similar for baseline parameters, including age (38, 23–50 and 38, 25.5–48.5 years), male gender (52.9% and 60.6%), extent of disease, extraintestinal manifestations (21.6% and 12.1%), use of 5-aminosalicylates (76.5% and 90.9%). The thiopurine use was lower in those having a flare (15.7% and 36.4%). Amongst the predictors of flare, the recent infections (39.2% and 30.3%), recent travel (31.4 and 27.3%), eating outside food (47.1% and 39.4%), consumption of milk products (88.2% and 75.8%), use of pain medication (43.1% and 33.3%) and recent stress (62.7% and 60.6%) were similar between cases and controls. The rates of antibiotic use (29.4% and 6.1%), lack of adherence (50.9% and 15.2%), and intake of CAM (70.6% and 33.3%) were higher in those with flare. Patients attributed a lack of adherence to the cost of therapy, presumed cure (due to lack of symptoms), and fear of adverse effects.ConclusionLack of adherence to inflammatory bowel disease therapies and recent CAM and antibiotic intake was higher in patients with flares of UC. The study makes ground for educational intervention(s) promoting knowledge and adherence to IBD therapies.

The Effects of Complementary Therapies on Patient-Reported Outcomes: An Overview of Recent Systematic Reviews in Oncology.

Many patients with cancer make use of complementary medicine alongside conventional medicine, but clinicians in oncology often lack the knowledge to adequately advise patients on the evidence base for complementary therapies. This study aims to provide an overview of recently published systematic reviews that assess the effects of complementary therapies on patient-reported health outcomes in patients with cancer. Systematic reviews, including a meta-analysis of at least two randomized controlled trials, were identified from the PubMed, Embase, Cochrane Library, CINAHL and PsycINFO databases. The methodological quality was assessed with AMSTAR 2. One hundred systematic reviews were included. The results suggest that several complementary therapies can improve health outcomes reported by patients with cancer, such as acupuncture to relieve pain, music interventions to reduce anxiety and yoga to improve cancer-related fatigue. The side effects related to complementary therapy use are generally mild. The results remain inconclusive for some intervention-outcome combinations. Many of the included systematic reviews insufficiently assessed the causes and impact of bias in their interpretation of the results. This overview of systematic reviews can support clinicians in counselling their patients on this topic and provide directions for future research and clinical practice guidelines in the field of complementary medicine.

Expert Consensus on the Role of Pharmaco-complementary Medicine for the Management of Diabetic Complications Using Modified Delphi Method

Background: Diabetes mellitus is a chronic metabolic disorder characterized by hyperglycemia resulting from insulin resistance and/or deficiency. It is associated with numerous complications, including microvascular and macrovascular complications. Micronutrient deficiencies are commonly observed in individuals with diabetes due to the metabolic changes that occur in the body and the increased renal excretion. Several studies have shown that diabetes patients are at an increased risk of developing micronutrient deficiencies such as vitamin D, thiamine, vitamin B12, folate, magnesium, and zinc. The consequences of micronutrient deficiencies in diabetic patients can be significant. The aim of this study was to achieve a consensus on the use of complementary pharmacological therapies in the management of diabetic complications, through a modified Delphi methodology. Methods: A three-round modified Delphi Procedure was conducted to define recommendations regarding the role of Pharmaco-Complementary medicine in the management of Diabetic complications using a web-based questionnaire. The questionnaire included a set of 65 questions. The level of Consensus was defined based on the level of agreement among the panelists on specific scientific statements. Strong Consensus was defined as ≥80% agreement, Moderate Consensus with Agreement between 65% and up to 79%, and Low Consensus level with statements below 65% agreement. Results: Eighteen experts in the field of diabetes participated in the development of this consensus. Three rounds of voting were held, followed by data analysis and consensus level calculation. Out of 47 statements, a total of 33 statements achieved moderate – strong consensus (moderate: 65% - 79% agreement, strong: ≥80% agreement). Conclusion: Experts concluded that the use of pharmaco-complementary medications such as CoQ10, Benfotiamine, Magnesium, and EPA can potentially improve glycemic control, insulin sensitivity, and manage diabetic complications. This consensus can serve as a valuable tool for clinicians in managing diabetes, and its complications, and can provide direction for future research. Keywords: Diabetes, Consensus; Pharmaco-complementary, Delphi, Complications

Teaching Evidence-Based Medicine and Non-conventional (Alternative) Therapies in Portuguese Veterinary Schools—A Curricular Assessment

Applying evidence-based veterinary medicine (EBVM) is considered a Day One competence for veterinary graduates. Furthermore, the increasing interest in the use of complementary and alternative (non-conventional) veterinary therapies (NCTs) must be grounded on EBVM principles. Few studies have mapped the teaching of EBVM and of NCTs and assessed their content. This study analyses the official curricula of six (out of eight) Portuguese veterinary schools in terms of EBVM and NCTs, using the self-evaluation documents submitted to the National Agency for Assessment and Accreditation of Higher Education (A3ES) (2014–2015). Results show that, with few exceptions, veterinary education in Portugal follows a traditional, clinically-driven approach to evidence, with concepts taught mostly from an empirical and experiential perspective instead of a systematic one. Core EBVM topics, such as placebo effect, methodological validity, PICO, cognitive bias, and systematic review are either absent or insufficiently covered. Moreover, the teaching of NCTs was found in three out of the six curricular programmes, namely acupuncture, phytotherapy, homeopathy, traditional Chinese medicine, aromatherapy, Bach flower remedies, ayurveda, energetic healing (reiki), and massage. We found no evidence that these therapies are being taught under the principles of EBVM. Taken together, these results highlight the need for more explicit and targeted teaching of EBVM-related topics, namely regarding the critical appraisal of scientific literature and the integration of best evidence into clinical decision-making. Results can also be useful to inform the accreditation process by the A3ES and by education quality assurance agencies in other jurisdictions.