Information Survey on the Use of Complementary and Alternative Medicine

Background and Objectives: Complementary and alternative medicines (CAMs) are generally considered non-scientific and poor effective therapies. Nevertheless, CAMs are extensively used in common clinical practice in Western countries. We decided to promote a Delphi consensus to intercept the opinion of Italian physicians on CAM use in clinical practice. Materials and Methods: We run a Delphi-based consensus, interviewing anonymously 97 physicians. Of these, only 78 participate to the questionnaire. Results: Consensus about agreement and disagreement have been reached in several topics, including indication, as well as safety issues concerning CAMs. Conclusions: The use of CAMs in clinical practice still lacks evidence. Experts agree about the possibility to safely use CAMs in combination with conventional medicines to treat non-critical medical conditions.

Acceptance and use of complementary and alternative medicine among medical specialists: a 15-year systematic review and data synthesis

Background Complementary and Alternative Medicine (CAM) has gained popularity among the general population, but its acceptance and use among medical specialists have been inconclusive. This systematic review aimed to identify relevant studies and synthesize survey data on the acceptance and use of CAM among medical specialists. Methods We conducted a systematic literature search in PubMed and Scopus databases for the acceptance and use of CAM among medical specialists. Each article was assessed by two screeners. Only survey studies relevant to the acceptance and use of CAM among medical specialists were reviewed. The pooled prevalence estimates were calculated using random-effects meta-analyses. This review followed both PRISMA and SWiM guidelines. Results Of 5628 articles published between 2002 and 2017, 25 fulfilled the selection criteria. Ten medical specialties were included: Internal Medicine (11 studies), Pediatrics (6 studies), Obstetrics and Gynecology (6 studies), Anesthesiology (4 studies), Surgery (3 studies), Family Medicine (3 studies), Physical Medicine and Rehabilitation (3 studies), Psychiatry and Neurology (2 studies), Otolaryngology (1 study), and Neurological Surgery (1 study). The overall acceptance of CAM was 52% (95%CI, 42–62%). Family Medicine reported the highest acceptance, followed by Psychiatry and Neurology, Neurological Surgery, Obstetrics and Gynecology, Pediatrics, Anesthesiology, Physical Medicine and Rehabilitation, Internal Medicine, and Surgery. The overall use of CAM was 45% (95% CI, 37–54%). The highest use of CAM was by the Obstetrics and Gynecology, followed by Family Medicine, Psychiatry and Neurology, Pediatrics, Otolaryngology, Anesthesiology, Internal Medicine, Physical Medicine and Rehabilitation, and Surgery. Based on the studies, meta-regression showed no statistically significant difference across geographic regions, economic levels of the country, or sampling methods. Conclusion Acceptance and use of CAM varied across medical specialists. CAM was accepted and used the most by Family Medicine but the least by Surgery. Findings from this systematic review could be useful for strategic harmonization of CAM and conventional medicine practice. Systematic review registration PROSPERO CRD42019125628 Graphical abstract

Use of Complementary and Alternative Medicine Among Patients With Epilepsy and Diabetes Mellitus, Focusing on the Outcome of Treatment

Introduction: Millions all over the world live with epilepsy, and they may require long-term drug treatment. The use and interest in complementary and alternative medicine (CAM) have grown over the previous years. Coadministration of herbal products with medicines may result in adverse drug reactions (ADRs) and/or unfavorable interactions. The aims of this study were to determine the prevalence of CAM use among patients with epilepsy, to compare the results to those of the patients with diabetes mellitus (DM), to reveal factors that may drive the use of CAM, and to measure outcomes and adherence. It was also our intent to have state-of-the-art information on CAM use in our region among patients with the two diseases above.Materials and Methods: We conducted a non-interventional study using a self-developed questionnaire. It was distributed among adult patients with either epilepsy or DM who also suffered from cardiovascular consequences. A database was compiled from the anonymous questionnaires filled in voluntarily by the patients. Basic statistics were used to analyze this database.Results: A total of 227 questionnaires were filled in by 127 patients (55.9%) with epilepsy and 100 patients (44.1%) with DM. Mean age was 54.54 ± 17.33 years. Of the patients, 50.2% were male. Average body weight was 80.3 ± 17.3 kg. Of the patients, 22 (9.7%) used CAM because they believed in CAM. Two of them reported ADRs. Among the patients with epilepsy, the ratio was only 7.9% compared to 12% among those with DM. While the number of CAM users was higher among younger patients with epilepsy, it was the elderly patients with DM who tended to use CAM.Conclusion: Attention should be paid to reliance on CAM during the follow-up. Our finding that health-conscious patients tend to use CAM more often (than the general population) may indicate it is necessary to discuss CAM usage sincerely. CAMs modulating cytochrome P450 (CYP) enzymes were the most common, leading to interactions with medication used and resulting in ADRs. This shows the importance of educating patients and treating team including clinical pharmacists in this field.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh

Background While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. Methods A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. Results Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12–0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35–18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34–2.85). Conclusion Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people’s health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

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

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.

CAM Use From Western and Asian Perspectives

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 Use in Slovakia: Results of a National Population Survey

The use of complementary and alternative medicine (CAM) in Europe has intensely increased in recent decades. To acquire information about the patterns and trends of CAM use in Slovakia, a nationwide representative survey was conducted on Slovakian adult population. A nationally representative cross-sectional survey was administered to the general population of Slovakian residents aged 18 years and over. The respondents were interviewed face-to-face by professional interviewers. Data were collected during September 2019 as a part of an omnibus survey on a variety of subjects. Altogether, 82.4% of the respondents reported either regular CAM method use or the lifetime prevalence of such use. The most frequently reported group of methods were biologically based treatments (78.9%), followed by manipulative and body-based methods (54.4%), mind-body interventions (31.9%), whole medical systems (18.2%), and energy therapies (4.2%). Vitamins (71.1%), herbal teas (68.1%), massages (53.6%), religious healing (20.3%), and special diets (18.8%) were the five most commonly preferred CAM modalities. Female gender, higher income and higher education are significant predictors of CAM use. The study highlights the association between satisfaction with healthcare systems, health situations, and the use of CAM.