Medicine Use In Patients Research Articles

The use of complementary medicine in patients referred for patch testing

The use of complementary medicine in patients referred for patch testing

Approaching complementary and alternative medicine use in patients with cancer: questions and challenges.

Complementary and alternative medicine (CAM) is becoming a significant factor in the arena of cancer care. There is an increasing body of research along with widespread popularity and use by patients with cancer. This article reviews current knowledge about the worldwide use of CAM in the treatment of cancer and patients' motives and reasoning for this use. Clinical research in CAM cancer treatments and physicians' attitudes toward this popular trend among patients with cancer are discussed as well. The physician-patient communication and its relevance to CAM use is emphasized. A step approach is suggested for primary care physicians including the discussion of CAM in the management of cancer in order to enrich the physician-patient dialogue and improve the quality of the clinical encounter.

A cross-sectional survey of complementary and alternative medicine use in patients with atopic dermatitis.

Studies from Europe reveal that a large percentage of patients with atopic dermatitis use some form of complementary and alternative medicine for the treatment of their skin disease. There are no studies from the United States that examine the prevalence and types of complementary and alternative medicine use among patients with atopic dermatitis. The goal of this study was to determine the prevalence of complementary and alternative medicine use and the patterns of this use among atopic dermatitis patients referred to a university clinic. Using a self-administered questionnaire, investigators performed a cross-sectional survey of 70 consecutive patients diagnosed with atopic dermatitis. Of the patients surveyed, 50.4% used some form of complementary and alternative medicine for the management of their skin disease. Common motivating factors were dissatisfaction with conventional treatment and frustration with the chronic nature of the condition. Vitamin supplementation and herbal creams were the most common alternative treatments used. The significant percentage of patients seeking alternative care for atopic dermatitis underscores the need for physicians to be familiar with alternative therapies for skin disease.

Phytotherapy in cardiovascular medicine

There is widespread use of herbal medicine in patients suffering from cardiovascular diseases. The discussion about the benefit of these drugs is still controversial because of lack of scientific evidence. Ginkgo biloba, Crataegus and Garlic are often recommended substances for patients with cardiovascular diseases. For these substances there is a lot of data available from experimental and clinical studies, unfortunately not always adhering to the criteria of evidence based medicine. Extracts from ginkgo biloba contain several active constituents, mainly flavonoids and terpens, which have antioxidative properties and an inhibitory effect on platelet aggregation by inhibiting platelet activation factor PAF. Ginkgo is mainly used in vascular dementia and peripheral vascular disease. Garlic shows a modest lipid-lowering effect in the same range as a low-cholesterol diet. Effect on blood pressure seems to be at best minor. Crataegus is often used in patients with heart failure because of its positive inotropic effect. Additionally, crataegus acts as an antiarrhythmic substance by prolonging refractory period of the action potential.

Alternative medicine use in patients with GORD

Alternative medicine use in patients with GORD

A hospital-based study on the use of alternative medicine in patients with chronic liver and gastrointestinal diseases.

To determine the extent to which Taiwanese patients use alternative medicine, we interviewed 500 consecutive patients with chronic liver and gastrointestinal disorders at an outpatient-service. Forty-two patients were excluded due to incomplete data. The percentages of patients with chronic liver (102/269, 37.9%) and gastrointestinal (74/189, 39.2%) diseases using alternative medicine were not significantly different (p = 0.70). The patients who used alternative medicine were not statistically different in gender (p = 0.37), age (p = 0.59), education level (p = 0.83), family income (p = 0.90), or occupation (p = 0.72). Only 36% (64/176) of patients informed their doctors of their use of alternative medicine. The kinds of alternative medicine used by the 176 patients included: Chinese/herbal medicine, 169 (96%); acupuncture, 31 (18%); nutritional supplements, 22 (13%); chiropractic, 17 (10%); scratching, 14 (8%); Qigong, 13 (7%); cupping, 13 (7%); and incense ash, 3 (2%). Sixty-six percent (111/169) of patients used Chinese/herbal medicine in addition to Western allopathic medicine. Only 11% (19/169) of them believed that Chinese/herbal medicine had side effects. Our study indicates the use of alternative medicine occurs across all demographic groups in one-third of patients with chronic liver and gastrointestinal diseases at a major general hospital in Taipei. We suggest that the doctors question all patients for history of alternative therapy use.

Alternative medicine use in patients with localized prostate carcinoma treated with curative intent

Alternative medicine use in patients with localized prostate carcinoma treated with curative intent

Alternative medicine use in patients with localized prostate carcinoma treated with curative intent

Alternative medicine therapies are estimated to be used by 7-64% of cancer patients but up to 72% do not inform their physician. To the authors' knowledge little useful information is available regarding the prevalence of alternative medicine use by patients with prostate carcinoma. Thus, the authors attempted to evaluate the prevalence of alternative medicine use by prostate carcinoma patients treated with curative intent by either radical prostatectomy, brachytherapy alone, or a combination of brachytherapy and external radiation therapy. Between January 1997 and May 1998, 234 men with clinically localized prostate carcinoma underwent radical prostatectomy (54 patients) or brachytherapy (180 patients) with (74 patients) or without (106 patients) external beam radiation therapy. In July 1998 a questionnaire was mailed to all patients comprised of multiple questions regarding alternative medicine use to which 190 patients (81%) responded. The overall prevalence and types of alternative medicine therapies used were assessed and the relation between age at procedure, pretreatment prostate specific antigen level, clinical stage, pretreatment Gleason score, and type of treatment with the use of alternative medicine therapies was evaluated using univariate and multivariate analysis. The prevalence of alternative medicine use by prostate carcinoma patients responding to the survey was 43% (81 of 190 patients). No significant differences in alternative medicine use were observed between the patients who received brachytherapy alone (38%), those who underwent radical prostatectomy (40%), and those treated with combined brachytherapy and external beam radiation therapy (51%). Vitamins, prayer or other religious practices, and herbal medicines were the most commonly used therapies in these patients. Higher pretreatment Gleason scores were associated with a greater use of alternative medicine therapies on both multivariate and univariate analyses. Finally, using multivariate analysis, younger prostate carcinoma patients were more likely to use alternative medicine therapies than older patients. Alternative medicine use is very prevalent among patients treated for localized prostate carcinoma. Because some of these treatments may have a potential biologic impact on tumor behavior and, consequently, on definitive or surrogate therapeutic endpoints, patients should be questioned carefully regarding alternative medicine use during routine tumor follow-up.

Patterns of alternative medicine use by cancer patients.

To assess the patterns of alternative medicine use in patients of a public hospital oncology unit, and to compare patients' experience of alternative with conventional medicine. Self-administered questionnaire survey of cancer patients attending specialist consulting rooms at the Royal North Shore Hospital and the Oncology Outpatient Clinic at Port Macquarie Base Hospital during August 1995. 507 patients attended the clinics; 335 (66%) returned questionnaires, of which 319 (62%) were sufficiently complete for analysis. Expectations of and satisfaction with both conventional and alternative treatment, use of alternative treatment, and patient characteristics associated with this use. Expectations of and satisfaction with both conventional and alternative treatment were very high. Alternative treatments (most commonly dietary and psychological methods) were used by 21.9% of patients. Median annual cost of alternative therapy was $530, with most patients reporting "value for money". Younger age and being married were positively associated, and satisfaction with conventional treatment was negatively associated, with alternative medicine use; 40% of patients did not discuss alternative medicine with their physician. A significant proportion of cancer patients use one or more forms of alternative therapy. The use of alternative therapy may reflect on deficiencies in the current standard of care.