Prevalence of Use and the Risk of Adverse Effects Associated with Complementary and Alternative Medicine in a Cohort of Patients Receiving Warfarin

2009 ◽  
Vol 43 (5) ◽  
pp. 875-881 ◽  
Author(s):  
Vivian Wy Leung ◽  
Stephen J Shalansky ◽  
Melissa K Lo ◽  
Esther A Jadusingh
Keyword(s):  
Vitamin E ◽  
Adverse Effects ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Vitamin K ◽  
Warfarin Therapy ◽  
Significant Difference ◽  
Cam Use ◽  
The Impact ◽  
Complementary And Alternative

Background The use of complementary and alternative medicine (CAM), including orally administered herbals, botanicals, vitamins, and supplements, may pose a risk to patients on warfarin therapy. Objective To estimate the prevalence of CAM use among patients taking warfarin and evaluate the impact of CAM exposure on the risk of warfarin-related adverse effects. Methods A survey was administered to hospital inpatients and clinic outpatients on drug exposure (including CAM) over the previous month, self-reported bleeding events, use of alcohol and vitamin K–rich foods, and medical conditions. Prescription medication use was verified, and laboratory records were checked for out-of-range international normalized ratios (INRs) (defined as INR >4 or <2). The use of CAM, including products with reported or theoretical interactions with warfarin, was compared between patients with and without self-reported bleeding or out-of-range INR. Results Among the 314 patients who completed the survey, 44.3% reported using CAM at least weekly. Potentially interacting CAM was used by 34.1% of all patients, or 18.2% if vitamin E was excluded as an interacting CAM. Vitamin E was used by 24.2% of all patients and 71.0% of those who used potentially interacting CAM. There was no significant difference in CAM use or consumption of vitamin K–rich foods between patients with and without INRs greater than 4 or for patients with and without INRs less than 2. Conclusions The use of potentially interacting CAM in this cohort was higher than the use previously reported among patients on warfarin therapy. However, exposure to CAM was not associated with an increase in the risk of self-reported bleeding or out-of-range INR.

scholarly journals DIPG-84. COMPLEMENTARY AND ALTERNATIVE MEDICINE IN DIFFUSE INTRINSIC PONTINE GLIOMA

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii303-iii304
Author(s):  
Fatma El-Khouly ◽  
Syed Adil ◽  
Harry Hendrikse ◽  
Gertjan Kaspers ◽  
Christof Kramm ◽  
...  
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Online Survey ◽  
Diffuse Intrinsic Pontine Glioma ◽  
Survey Study ◽  
Pontine Glioma ◽  
Anticancer Effects ◽  
Significant Difference ◽  
Cam Use ◽  
Complementary And Alternative

Abstract INTRODUCTION Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a two-year survival rate of ≤10%. In this international survey study we aim to evaluate the use of complementary and alternative medicine (CAM) in this patient population. METHODS Parents of-, and physicians treating DIPG patients were asked to participate in a retrospective online survey with questions regarding CAM use during time of illness. RESULTS 120 parents and 75 physicians contributed to the online survey between January and May 2020. Physicians estimated that &lt;50% of their patients used CAM, whereas 69% of the parents reported to have used CAM to treat their child during time of illness. Cannabis was the most widely used form of CAM, followed by vitamins and minerals, melatonin, curcumin and boswellic acid. CAM was mainly used to actively treat the tumor. Other motivations were to treat side effects of chemotherapy, or to comfort the child. Children diagnosed ≥2016 were more likely to use CAM (χ2=6.08, p=0.014). No significant difference was found between CAM users and non-users based on ethnicity (χ2=4.18, p=0.382) and country of residence (χ2=9.37, p=0.154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. CONCLUSION This survey demonstrates that worldwide a considerable number of DIPG patients use CAM. Physicians should be more aware of potential CAM use and more actively discuss the topic. More research is needed to gain knowledge about possible anticancer effects of CAM and their interactions with conventional therapies.

CAM Use From Western and Asian Perspectives

2022 ◽  
pp. 13-25
Author(s):  
Dawn-Marie Walker ◽  
Mayuree Tangkiatkumjai
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Placebo Effect ◽  
Cam Use ◽  
Similarities And Differences ◽  
The Impact ◽  
Complementary And Alternative

This chapter will discuss the impact on the provision and integration of complementary and alternative medicine (CAM) into the patient's medical pathway and in turn, the prevalence of usage, not only for treatment but also prevention. Similarities and differences of these issues between Western and Asian perspectives will be presented. The authors will provide an overview of regulatory organisations which influence this provision, as well as advertising within the cultures which will have impact on belief of efficacy, which in turn will increase the placebo effect (thereby increasing efficacy). Due to a lack of evidence for CAM advertising in Asian cultures, further research is needed.

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

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.

scholarly journals Patterns of Complementary and Alternative Medicine Use, Perceived Benefits, and Adverse Effects among Adult Users in Enugu Urban, Southeast Nigeria

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Ijeoma Okoronkwo ◽  
Jane-lovena Onyia-pat ◽  
Pat Okpala ◽  
Mary-Ann Agbo ◽  
Afam Ndu
Keyword(s):  
Adverse Effects ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Conventional Medicine ◽  
Cross Sectional Study ◽  
Perceived Benefits ◽  
Cross Sectional ◽  
Major Route ◽  
Cam Use ◽  
Complementary And Alternative

The use of complementary and alternative medicine (CAM) is now on the increase. Evidence from studies carried out globally has established that CAM use is very common and varies among populations. This study investigated patterns of CAM use, perceived benefits, and associated harm with CAM use among adults. A cross-sectional study was conducted in three local government areas of Enugu urban, Southeast Nigeria. An interviewer-administered questionnaire was used to collect data from all consenting adult participants aged between 18 and 65 years. Of the 732 participants interviewed, 62.8% were females while 37.2% were males. Majority (84.7%) of the participants had used CAM at one time or another. The most commonly used CAM product was the biological products, followed by spiritual therapy. The major route of administration for CAM products was oral and about 40% of the participants combined CAM with conventional medicine. Majority (78.6%) of CAM users benefited from CAM products after using them while a few complained of adverse reactions. As CAM is gaining widespread acceptance and use, there is need for clinical trial on the benefits and adverse effects associated with the use of CAM to facilitate proof of efficacy and safety of the products.

CAM Use From Western and Asian Perspectives

2017 ◽  
pp. 24-42
Author(s):  
Dawn-Marie Walker ◽  
Mayuree Tangkiatkumjai
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Placebo Effect ◽  
Cam Use ◽  
Similarities And Differences ◽  
The Impact ◽  
Complementary And Alternative

This chapter will discuss the impact on the provision and integration of complementary and alternative medicine (CAM) into the patient's medical pathway and in turn, the prevalence of usage, not only for treatment but also prevention. Similarities and differences of these issues between Western and Asian perspectives will be presented. The authors will provide an overview of regulatory organisations which influence this provision, as well as advertising within the cultures which will have impact on belief of efficacy, which in turn will increase the placebo effect (thereby increasing efficacy). Due to a lack of evidence for CAM advertising in Asian cultures, further research is needed.

Complementary and alternative medicine: What do oncology healthcare providers think?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20614-e20614
Author(s):  
C. S. Tung ◽  
C. C. Sun ◽  
L. Cohen ◽  
M. Frenkel ◽  
L. M. Ramondetta ◽  
...  
Keyword(s):  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Healthcare Providers ◽  
Comfort Level ◽  
Comprehensive Cancer Center ◽  
Relaxation Techniques ◽  
Number Of Patients ◽  
Significant Difference ◽  
Cam Use ◽  
Complementary And Alternative

e20614 Background: The use of complementary and alternative medicine (CAM) is growing as the oncology patient (pt) population increases. The purpose of this study was to assess current CAM practice patterns of oncology healthcare providers. Methods: We distributed a 20-page anonymous survey to all physicians (), mid-level practitioners, clinical pharmacists, and dietitians at a comprehensive cancer center. The survey examined factors influencing a provider's inquiry towards pt CAM use, as well as current perception and use of 15 different CAM modalities, such as meditation, acupuncture, chiropractic, and herbal therapy. Descriptive statistics, chi-square, and Student's t-test were used for analysis. Results: 671/1,601 (42%) surveys were returned with s comprising 50% of the responses. 83% of respondents believed CAM has a role in cancer care. Over 70% indicated that massage, meditation/prayer, relaxation techniques, and acupuncture have potential uses, primarily to relieve symptoms not controlled by conventional therapy (tx) (47%) and as psycho-social-spiritual support (47%). Respondents estimated 28% of pts utilize CAM; 25% of respondents and 19% of pts initiated CAM discussions during pt visits. Those in medicine-based fields were more likely to discuss pt CAM use compared to surgical specialities (30% vs. 19%, p<0.01), but there was no significant difference in comfort level to discuss CAM modalities. s were less likely to discuss CAM use compared to all other providers (21% vs. 31%, p<0.01). s were also less comfortable discussing herbs (37% vs. 51%, p<0.01), massage (73% vs. 82%, p<0.05), meditation/prayer (71% vs. 82%, p<0.05), and relaxation tx (67% vs. 77%, p<0.01) compared to all other providers but more comfortable discussing acupuncture (63% vs. 55%, p<0.05). Respondents cited lack of knowledge in CAM as the primary reason for not discussing CAM with pts. Conclusions: Past studies estimate that >50% of patients use at least one form of CAM. Our study suggests that oncology providers critically underestimate the number of patients incorporating CAM into their treatment. Improving provider education on CAM therapies is essential to improve patient-physician communication regarding potential risks and benefits of CAM with traditional cancer therapies. No significant financial relationships to disclose.

scholarly journals Complementary and Alternative Medicine Use in Breast Cancer Patients at a Medical Center in Taiwan: A Cross-Sectional Study

2020 ◽  
Vol 19 ◽  
pp. 153473542098391
Author(s):  
Chieh-Ying Chin ◽  
Yung-Hsiang Chen ◽  
Shin-Chung Wu ◽  
Chien-Ting Liu ◽  
Yun-Fang Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Alternative Medicine ◽  
Complementary And Alternative Medicine ◽  
Cancer Patients ◽  
Medical Center ◽  
Cancer Center ◽  
Breast Cancer Patients ◽  
Cross Sectional ◽  
Cam Use ◽  
Complementary And Alternative

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.

Sign in / Sign up

Export Citation Format

Share Document