P04.65. Development and validation of an instrument for measuring decision making about complementary and alternative medicine (CAM) use among cancer patients

Background Complementary and alternative medicine (CAM) is becoming more common in medical practice, but little is known about the concurrent use of CAM and conventional treatment. Therefore, the aim was to investigate the types of CAM used and their prevalence in a regional patient cohort with breast cancer (BC). Methods BC patients were interviewed with a structured questionnaire survey on the use of CAM in southern Taiwan at an Integrative Breast Cancer Center (IBCC). The National Centre for Complementary and Integrative Health (NCCIH) classification was used to group responses. Over a period of 8 months, all patients receiving treatment for cancer at the IBCC were approached. Results A total of 106 BC patients completed the survey (response rate: 79.7%). The prevalence of CAM use was 82.4%. Patients who were employed, were receiving radiotherapy and hormone therapy, and had cancer for a longer duration were more likely to use CAM ( P < .05). Multivariate analysis identified employment as an independent predictor of CAM use (OR = 6.92; 95% CI = 1.33-36.15). Dietary supplementation (n = 69, 82.1%) was the type of CAM most frequently used, followed by exercise (n = 48, 57.1%) and traditional Chinese medicine (n = 29, 34.5%). The main reason for using CAM was to ameliorate the side effects of conventional therapies. Almost half (46.4%) of these CAM users did not disclose that they were using it in medical consultations with their physicians. Most chose to use CAM due to recommendations from family and friends. Conclusion A large portion of BC patients at the IBCC undergoing anti-cancer treatment courses used CAM, but less than half discussed it with their physicians. Given the high prevalence of CAM, it would be justifiable to direct further resources toward this service so that cancer patients can benefit from a holistic approach to their treatment.

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Critical Review of Complementary and Alternative Medicine Use in Amyotrophic Lateral Sclerosis: Prevalence and Users’ Profile, Decision-Making, Information Seeking, and Disclosure in the Face of a Lack of Efficacy

Neurodegenerative Diseases ◽

10.1159/000492946 ◽

2018 ◽

Vol 18 (4) ◽

pp. 225-232 ◽

Cited By ~ 2

Author(s):

Jon Adams ◽

Michael Lee ◽

Wenbo Peng

Keyword(s):

Decision Making ◽

Amyotrophic Lateral Sclerosis ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Information Seeking ◽

Disease Process ◽

Cam Use ◽

Als Patients ◽

Lateral Sclerosis ◽

Complementary And Alternative

Background: Despite a lack of evidence of clinical efficacy for complementary and alternative medicine (CAM) use in amyotrophic lateral sclerosis (ALS), these medicines remain popular around the world. Objective: To examine the prevalence and cost of CAM use in ALS and CAM users’ profile, decision-making, information seeking, and disclosure among ALS patients. Methods: A comprehensive literature search was conducted of MEDLINE, CINAHL/SCOPUS, and AMED databases from their inception to April 2018. This review followed PRISMA guidelines and employed a quality scoring system to assess the included papers. Results: Seven papers met the inclusion criteria and were thematically analysed. ALS patients utilized a range of CAM therapies and/or products, with acupuncture and vitamins being the most frequently reported. CAM modalities were often employed concurrently with conventional medications throughout the disease process. Although some ALS patients reported positive experience regarding CAM use, many were reluctant to disclose their CAM use to their clinicians. Research focusing on CAM use in ALS remains ad hoc and restricted to only a few countries. The rigour and quality of this research field to date has been varied, predominantly drawing upon regional/localized data and failing to report CAM users’ characteristics. Conclusion: A proportion of ALS patients report utilizing CAM concurrently with conventional treatments. Such use, set amidst a dearth of evidence for the efficacy of CAM in ALS, poses potential direct and indirect risks to patient care, and medical providers should be mindful of and enquire about CAM use when treating ALS patients.

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Communication about Complementary and Alternative Medicine in Danish Oncological Settings: An Intervention Study

Complementary Medicine Research ◽

10.1159/000507565 ◽

2020 ◽

Vol 27 (6) ◽

pp. 392-400

Author(s):

Nina Nissen ◽

Sara Seerup Laursen ◽

Henriette Knold Rossau

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Health Professionals ◽

Intervention Study ◽

Care Providers ◽

Sources Of Information ◽

Before And After ◽

Cam Use ◽

Complementary And Alternative

Purpose: Communication about complementary and alternative medicine (CAM) between cancer patients and health professionals rarely takes place. This article reports on an intervention study that aimed to support communication about the use and effects of CAM between cancer patients and care providers. Methods: The intervention consisted of the use of evidence-based information material (website; leaflet) about the effects of CAM for cancer. Focus groups with cancer patients, relatives, nurses and doctors (n = 50) determined the preferred content and format of materials and evaluated the intervention. The information material was informed by a related systematic metareview of literature. A survey identified patient participants’ CAM use, information sources, and the extent of communication about CAM before and after the intervention. Results: No significant impact of the intervention on communication about CAM for cancer patients, patients’ CAM use or sources of information was identified. Health professionals disseminated the leaflet only in response to patients raising the topic; the website was not accessed during consultations. The intervention and information materials were well received. Conclusion: Cancer patients and care providers wish to improve communication about CAM. Nevertheless, patients and professionals wait for the other to broach the subject of CAM. This reflects a “culture of waiting.”

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Prevalence and Correlates of Complementary and Alternative Medicine Use among Patients with Lung Cancer: A Cross-Sectional Study in Beirut, Lebanon

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2017/8434697 ◽

2017 ◽

Vol 2017 ◽

pp. 1-11 ◽

Cited By ~ 8

Author(s):

Farah Naja ◽

Bilal Anouti ◽

Hibeh Shatila ◽

Reem Akel ◽

Yolla Haibe ◽

...

Keyword(s):

Lung Cancer ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Well Being ◽

Open Communication ◽

Cross Sectional ◽

Lung Cancer Patients ◽

Cam Use ◽

Complementary And Alternative

Patients with lung cancer are increasingly seeking complementary and alternative medicine (CAM) to improve their physiological and psychological well-being. This study aimed to assess CAM use among lung cancer patients in Lebanon. Using a cross-sectional design, 150 lung cancer patients attending the Basile Cancer Institute at the American University of Beirut Medical Center were interviewed. Participants completed a questionnaire addressing sociodemographic characteristics, lung cancer condition, and use of CAM. The main outcome of interest was “use of any CAM therapy since diagnosis.” Prevalence of CAM use was 41%. The most commonly used CAM modality among study participants was “dietary supplements/special foods.” Results of the multiple logistic regression analyses showed that CAM use was positively associated with Lebanese nationality and paying for treatment out of pocket and was negatively associated with unemployment and having other chronic diseases. About 10% of patients used CAM on an alternative base, 58% did not disclose CAM use to their physician, and only 2% cited health professionals as influencing their choice of CAM. This study revealed a prevalent CAM use among lung cancer patients in Lebanon, with a marginal role for physicians in guiding this use. Promoting an open-communication and a patient-centered approach regarding CAM use is warranted.

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Predictors of Complementary and Alternative Medicine Use in Cancer Care: Results of a Nationwide Multicenter Survey in Korea

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2012/212386 ◽

2012 ◽

Vol 2012 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Ji-Yeon Shin ◽

So Young Kim ◽

Boyoung Park ◽

Jae-Hyun Park ◽

Jin Young Choi ◽

...

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Cancer Care ◽

Multivariate Logistic Regression Analysis ◽

Multicenter Survey ◽

Cam Use ◽

Nationally Representative ◽

Time Since Diagnosis ◽

Complementary And Alternative

Background. Although studies have shown that the use of complementary and alternative medicine (CAM) is common in cancer patients, few surveys have assessed CAM use and associated factors in various cancers in Korea.Objectives. We explored factors predicting CAM use among a nationally representative sample of cancer patients.Methods. In total, 2,661 cancer patients were administered questionnaires about their CAM use and factors that might predict CAM use including sociodemographics, clinical and quality-of-life factors, time since diagnosis, trust in physicians, trust in hospitals, satisfaction, and informational needs. Data were analyzed using Pearson’sχ2tests and multivariate logistic regression analysis.Results. Overall, 25.5% reported that they had used or were using CAM. Higher income, presence of metastasis, longer time since diagnosis, less trust in hospitals, lower overall satisfaction, and higher degree of informational need were significantly associated with CAM use.Conclusions. The use of CAM in patients with cancer can be interpreted as an attempt to explore all possible options, expression of an active coping style, or expression of unmet needs in the cancer care continuum. Physicians need to openly discuss the use of CAM with their patients and identify whether they have other unmet supportive needs.

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Plant-based Complementary and alternative medicine used by breast cancer patients at the Hospital Universitario San Ignacio in Bogotá, Colombia.

Universitas Scientiarum ◽

10.11144/javeriana.sc17-3.pbca ◽

2012 ◽

Vol 17 (3) ◽

pp. 291

Author(s):

Luz Angela Diaz ◽

Lilian Torregrosa ◽

Luisa Benavidez ◽

Marcela Mercado ◽

Susana Fiorentino

Keyword(s):

Breast Cancer ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Breast Cancer Patients ◽

Cam Use ◽

Self Administered Questionnaire ◽

Oncology Center ◽

Immunomodulatory Potential ◽

Complementary And Alternative

The present study estimates the frequency of the use of plant-based Complementary and Alternative Medicine (CAM) by breast cancer patients. From June to December of 2011, a self-administered questionnaire was given to 404 breast cancer patients receiving outpatient therapy at the Javeriana Oncology Center of the Hospital Universitario San Ignacio in Bogotá. The prevalence of patient CAM use was 57%, out of which 76% was based on plants like anamú, aloe, red fruits and soursop. Sixty-five percent of the patients had a positive perception of using medicinal plants and 57% used them simultaneously with the oncologist recommended allopathic treatment. We concluded that the frequency of CAM use in breast cancer patients at the Javeriana Oncology Center is within the prevalence range reported worldwide, despite differences in CAM types and frequencies. The high rates of plant-based CAM use without physician consent, brings about the lack of assessment of the synergic or antagonistic effects of CAM therapies on the allopathic treatment of breast cancer and evaluation of the antitumor and immunomodulatory potential of the traditionally used plants.

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Complementary and alternative medicine (CAM) use in cancer patients of immigration background.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12019 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12019-12019

Author(s):

Alex Wu ◽

Yunhong Wu ◽

PRABHSIMRANJOT SINGH ◽

Vijaya Natarajan ◽

Waseem Cheema ◽

...

Keyword(s):

African American ◽

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Latin American ◽

Symptom Relief ◽

Foreign Born ◽

The Us ◽

Cam Use ◽

Complementary And Alternative

12019 Background: Cancer patients are more likely to use complementary and alternative medicine (CAM) than non-cancer patients for immune enhancement and symptom relief. Cancer patients with immigration background may seek out CAM use more readily due to the influence from their cultural background. Methods: We carried out a prospective questionnaire study surveying the use of 21 CAM types to cancer patients between 10/23/2015 and 10/31/2020, to evaluate the association of CAM use with patients’ age, sex, cancer types, stages, race/ethnicity, birthplace, immigration duration, first language, marital status, levels of poverty, education and anxiety. Results: 658 patients were included in this analysis. The median age was 62 years old. The prevalence of CAM use was 66.11%. CAM use was higher in females (71.98%) than the males (54.34%) (p = 1.13x10-5), and higher in patients ≥ 38 years old (67.09%) than < 38 years old (46.88%) (p = 0.0215). Patients of African American descent (both US born and foreign born) (n = 198) had statistically higher CAM use (72.73%) than the Caucasians and Others (including Middle-Eastern, Multi-Racial and Others) (n = 266) (63.53%) (p = 0.0371). There was no difference of CAM use between the US born patients (n = 301, CAM use 68.77%) and the immigrants (n = 347, CAM use 63.98%) as a whole; however, Asian born immigrants (n = 106) had statistically less CAM use (53.77%) than the US born and other non-Latin American born (n = 397, CAM use 66.50%) (p = 0.0161), while the Latin-American born had a trend towards higher CAM use (74.83%, P = 0.0608). The number of years living in the US by the immigrants did not have an association with CAM use. Among psychosocial economic factors, married patients had a lower CAM use (61.23%) than the unmarried group (defined as divorced, separated, widowed, or single status, 70.85%) (p = 0.0102). The levels of education, poverty and anxiety did not show a statistical difference in relation to CAM use. Earlier stages of disease had numerically higher CAM use than stage 4 patients, and patients with breast and GYN cancers had higher CAM use (72.30%, p = 0.00252), consistent with the data on the higher CAM use in females. Prayer and spirituality and Dietary medicine were the 2 most common CAM types used (25.91% and 16.12%, respectively). African Americans of the combined US and Non-US origin showed the highest rate of using Prayer and spirituality (84.72%), versus Hispanics (71.19%), Caucasians (53.85%), and Asians (40.32%). Chiropractic therapy was exclusively used by Caucasian CAM users (9.38%). Conclusions: Among cancer patients of multi-ethnic groups with immigration background served in a community hospital in Brooklyn, New York, CAM use appeared to be higher in the African American patients, and lower in the patients born in Eastern Asia, as compared to the US born, or to Caucasians. Cultural roots appeared to be a strong influencing factor among all the medical and socioeconomic factors.

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Complementary and Alternative Medicine (CAM) use in Cancer Patients of Immigration Background

10.21203/rs.3.rs-1115141/v1 ◽

2022 ◽

Author(s):

Alex Wu ◽

Yunhong Wu ◽

Vijaya Natarajan ◽

Prabhsimranjot Singh ◽

Waseem Cheema ◽

...

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Latin American ◽

Asian Americans ◽

Symptom Relief ◽

The Us ◽

Cam Use ◽

The Impact ◽

Complementary And Alternative

Abstract Background: Previous studies have shown that cancer patients are more likely to use complementary and alternative medicine (CAM) than non-cancer patients for immune enhancement and symptom relief. We hypothesized that cancer patients with immigration background may seek out CAM use more readily than the US born patients due to the impact from their cultural background.Methods: This is a prospective, single institution, questionnaire study on cancer patient for the use of CAM. Correlates of CAM use with age, sex, cancer types, stages, race, birthplace, immigration duration, first language use, marital status, levels of poverty, education and anxiety, were studied.Results: Among 658 patients, the prevalence of CAM use was 66.11%. CAM use was 71.98% in females and 54.34% in males (p=1.13x10-5), 67.09% in patients ≥ 38 years old and 46.88% in patients < 38 years old (p=0.0215). Patients of African descent had higher CAM use (72.73%) than the Caucasians and Others (63.53%) (p=0.0371). There was no difference of CAM use between the US born (68.77%) and the immigrants (63.98%) as a whole; however, Asian born immigrants had lower CAM use (53.77%) than the US born (66.50%) (p=0.0161), while the Latin-American born had a trend towards higher CAM use (74.83%, P=0.0608). The number of years living in the US by the immigrants did not have an association with CAM use. Among psychosocial economic factors, married patients had a lower CAM use (61.23%) than the unmarried (70.85%) (p=0.0102). The levels of education, poverty and anxiety did not show a statistical difference in relation to CAM use, nor was the difference between the early or late stages of disease. Prayer and spirituality, and Dietary medicine were the two most common CAM subtypes used (25.91% and 16.12%, respectively). African Americans showed the highest rate of using Prayer and spirituality (84.72%) while the Asian Americans had the lowest rate (40.32%). Conclusions: Among cancer patients of multi-ethnic and immigration background, CAM use was higher in African American patients, and lower in Asian Americans, as compared to the US born, or to Caucasians. Cultural roots appeared to be a strong influencing factor for the selection of CAM.

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A pilot international survey of oncologists’ opinions and self-reported practice patterns on complementary and alternative medicine

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.19526 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 19526-19526

Author(s):

R. T. Lee ◽

F. J. Hlubocky ◽

J. J. Hu ◽

R. Stafford ◽

C. K. Daugherty

Keyword(s):

Alternative Medicine ◽

Complementary And Alternative Medicine ◽

Cancer Patients ◽

Practice Patterns ◽

Mainland China ◽

The United States ◽

Medical Systems ◽

Continued Education ◽

Cam Use ◽

Complementary And Alternative

19526 Background: Prior research has indicated that the prevalence of complementary and alternative medicine (CAM) use among cancer patients often exceeds 80%. Information about the prevalence of CAM use is important because many biologically-based therapies or alternative medical systems can potentially interfere with chemotherapy efficacy and increase the risk for treatment related toxicity and other complications. Methods: In 2004–2005, oncologists from the United States, mainland China, and Taiwan were surveyed regarding their perceptions and self-reported practice patterns regarding CAM. Results: A total 95 oncologists returned surveys providing a 38.2% response rate. Four out of five respondents (78%) felt unprepared to integrate CAM modalities into their practice. However, 71% reported they would allow CAM use during active cancer treatment, even in the setting of curable disease. Surveyed Chinese/Taiwanese oncologists were more likely than their US colleagues to inquire about their patients use of CAM (ask >10% of patients) - 80.6% vs. 52.4% (p<0.05). The same was true for individuals who felt their previous training had prepared them for CAM use, as compared to those who felt unprepared (80.9% vs. 57.0% (p<0.01). Chinese/Taiwanese respondents felt no more prepared for CAM use than US respondents (25.8.1% vs. 20.6%, p=0.57), were less likely to report integrating CAM with curable disease (48.3% vs. 69.8%, p<0.05), and were more likely to report concern about patients’ motivations for CAM use (83.9% vs. 46.8%, p<0.01). Conclusions: Despite a stated lack of preparedness, the majority of surveyed oncologists would allow cancer patients with curable disease to integrate CAM therapies. Although routinely exposed to CAM modalities, such as traditional Chinese medicine, responding Chinese/Taiwanese oncologists felt just as unprepared as their US colleagues. In addition, increased concern about patients’ motivations was associated with decreased integration of CAM. Continued education is needed to improve oncologists’ knowledge about patients’ use of CAM. No significant financial relationships to disclose.

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