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.

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.

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.

An Overview of Publications of Complementary and Alternative Medicine Research

This chapter presents an overview of the quantity and quality of clinical research in CAM and publication bias. Descriptive studies and their systematic reviews on CAM, e.g., prevalence and reasons for CAM use, have been widely conducted worldwide. The findings of the efficacy of herbal medicine, traditional Chinese medicine and acupuncture for treating various illnesses, have been highly published. Publications of CAM safety are limited. A number of clinical studies of CAM in treating kidney diseases were lower than other illnesses. Studies of Ayurveda and other CAMs are still lacking. The quality of CAM publications is described based on systematic reviews of assessing CAM publications. Publication bias is explained in terms of selective publications and location bias, language bias and conflict of interest. The mainstream journals are more likely to publish positive findings. Predatory open access and recommendations for assessing predatory journals are addressed in this chapter.

Thinking magically or thinking scientifically: Cognitive and belief predictors of complementary and alternative medicine use in women with and without cancer diagnosis

Background Complementary and alternative medicine (CAM) is popular among the general population and patients with various diseases, but our understanding of the predictors of CAM use for the population of women with or without cancer diagnosis is still quite limited. This paper examines predictors of attitudes toward and use of CAM, including cognitive factors (scientific reasoning, health literacy, locus of control), beliefs (holistic and magical health beliefs pseudoscientific beliefs, and trust in doctors), sociodemographic factors, and cancer diagnosis. Methods The sample consisted of 177 women (103, 58.2% without cancer, 74, 41.8% with cancer diagnosis; Mage = 38.81, SD = 11.43). Results Pseudoscientific/magical beliefs and external locus of control were the strongest predictors of positive attitudes toward CAM and its higher use, as well as preference for CAM instead of conventional treatment. Cancer diagnosis predicted only higher CAM use, but not more positive attitudes to CAM, nor preference for CAM instead of conventional medicine. There was no difference between women with and without cancer diagnosis in using CAM after we controlled for age and education. Women in our sample had a similar level of magical beliefs, holistic health beliefs, and attitudes toward CAM regardless of their cancer diagnosis. However, women with cancer had significantly more pseudoscientific beliefs than women without cancer and a higher external locus of control over their health. Conclusion Women who have an inclination toward holistic and magical beliefs about health tend to favor CAM treatments independently of the cancer diagnosis, although the diagnosis of cancer also contributes to their higher use of CAM. In other words, it seems improbable that women would turn toward CAM treatment only after being diagnosed with cancer.

Prevalence of Complementary And Alternative Medicine Use In Brazil: Results of The National Health Survey, 2019

Background: In recent decades, it has been possible to observe an increase in Complementary and Alternative Medicine (CAM) usage globally for both disease prevention and health promotion purposes. We aim to analyze factors associated with the prevalence of CAM use in Brazil. Methods: Observational study with data from the 2019 National Health Survey that evaluated a sample of Brazilian adults. The outcome was CAM use, such as acupuncture, homeopathy, medicinal plants and herbal medicines, meditation, and yoga in the last 12 months. A logistic regression model with a 95% confidence interval was estimated to assess factors associated with CAM use. Results: The prevalence of CAM use in 2019 was 5.2% (CI99%=4.8%-5.6%), the most used being: medicinal plants and herbal medicines, with a prevalence of 3.0% (CI99%=2.7-3.33) followed by: acupuncture 1.4% (CI99%=1.3-1.6) homeopathy 0.9% (CI99%=0.7-1.0), meditation 0.7% (CI99%=0.6-0.8) and yoga 0.4% (CI99%=0.4-0.5). We observed important differences in CAM use in Brazil, with a higher prevalence in the North Region, 3.7% (CI99%=2.81-4.75), where herbal medicines were more frequent the in the other regions. After estimating an adjusted model, women, older people, and people with a higher level of education and per capita income were the ones who most used all types of CAM. The practice of yoga stands out among women 3.6% (CI99%=2.49-5.28) and among individuals with higher per capita income 7.5% (CI99%=2.97-18.93); meditation among individuals with higher educational level 13.4% (CI99%=6.41-28.33) and acupuncture for those who declared regular or poor health 1.9% (CI99%=1.51-2.39). Conclusions: We recommend that the Ministry of Health expand CAM access to Unified Health System users and promote health professionals' conscious and guided use for the Brazilian population.