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Gutiérrez-Sánchez B, Gutiérrez-Gascón J, da-Silva-Domingues H, del-Pino-Casado R. Complementary and Alternative Therapies (CATs) in Nursing Education in Spanish Universities. NURSING REPORTS 2024; 14:2283-2290. [PMID: 39311177 PMCID: PMC11417894 DOI: 10.3390/nursrep14030169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2024] [Revised: 09/03/2024] [Accepted: 09/04/2024] [Indexed: 09/26/2024] Open
Abstract
BACKGROUND The use of complementary therapies in the general population is increasing, so it is necessary to understand the training that health professionals receive in this type of therapy in their training plans, as they are often the primary source of information for patients. Our aim was to investigate Spanish universities that offer subjects on complementary therapies in their nursing degree programs. METHODS This study is an observational, descriptive, cross-sectional study. For this purpose, we used a document published on the website of the Ministry of Universities as the working document. Additionally, a literature search was conducted up to September 2023 in the PubMed database, along with reverse searches. RESULTS Out of a total of 62 universities, only 16 (29%) offer a subject related to this type of therapy, 27.5% (11) are public universities and 22.7% (5) are private universities, most of them being optional subjects. CONCLUSIONS The training content on complementary care in nursing degree programs in Spanish universities is scarce, highlighting the potential benefit of expanding and promoting it, in line with the recommendations of the World Health Organization.
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Affiliation(s)
| | - José Gutiérrez-Gascón
- Department of Nursing, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (B.G.-S.); (H.d.-S.-D.); (R.d.-P.-C.)
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Kosiyakul P, Jitprapaikulsan J, Rattanathamsakul N, Siritho S, Sangsai O, Aueaphatthanawong K, Engchuan M, Prayoonwiwat N. Use of Complementary and Alternative Medicine in Patients With Idiopathic Inflammatory Demyelinating Diseases of the Central Nervous System: A Cross-Sectional Study in Thailand. CURRENT THERAPEUTIC RESEARCH 2024; 100:100749. [PMID: 38808155 PMCID: PMC11130686 DOI: 10.1016/j.curtheres.2024.100749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 04/21/2024] [Indexed: 05/30/2024]
Abstract
Background Complementary and alternative medications (CAM) are common among patients with multiple sclerosis (MS) for physical and psychological support. However, there is insufficient data regarding the application of CAM in the different cultures and beliefs of each community as well as patient's status. Objective To evaluate the prevalence and modalities of the use of CAM among patients with central nervous system idiopathic inflammatory demyelinating diseases (CNS-IIDD) in a tertiary care hospital. Methods A cross-sectional study was conducted at Siriraj Hospital from June to December 2021 involving patients with MS, neuromyelitis optic spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD), idiopathic transverse myelitis (iTM), and optic neuritis (ON) to examine the prevalence and mode of CAM use and its correlation with patient characteristics. Results There were 107 patients. The diagnoses were MS (38), NMOSD (55), MOGAD (5), iTM (7), and ON (2). Most of the patients were female (89.7%), and 61.7% were diagnosed over 5 years. The mean Expanded Disability Status Scale was 2.63 (S.D., 2.38), and the median ambulation index was 0 (range 0-8.5). There were 68 patients (63.6%) with a history of CAM use for at least 3 months, while those with current use decreased to 62 (58.5%). Vitamins and minerals were the most commonly used, particularly vitamin D (97.1%) and calcium (47.7%). Both treatments were primarily prescribed (95.3%) rather than self-administered (24.3%). The main reasons for the use of CAM were to strengthen their health (48.6%) and relieve existing symptoms (28.0%). Conclusions The use of CAM is common among patients with Thai CNS-IIDD. Further exploration of patient perspectives and preferences regarding CAM usage may contribute to a more comprehensive management approach for patients with CNS-IIDD.
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Affiliation(s)
- Punchika Kosiyakul
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Jiraporn Jitprapaikulsan
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Natthapon Rattanathamsakul
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Sasitorn Siritho
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Bumrungrad International Hospital, Bangkok, Thailand
| | - Onpawee Sangsai
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Kamonchanok Aueaphatthanawong
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Montira Engchuan
- Department of Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Naraporn Prayoonwiwat
- Division of Neurology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
- Siriraj Neuroimmunology Center, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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Liu J, Zhang C, Xie Y, Zhou L, Guo L, Li B, Jia Z, Zhang J, Sugimoto K, Gao Y. Demyelinating diseases of the central nervous system registry for patients with traditional Chinese medicine: Rationale and design of a prospective, multicenter, observational study. Front Pharmacol 2022; 13:981300. [DOI: 10.3389/fphar.2022.981300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 11/14/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Traditional Chinese medicine (TCM), a main form of complementary and alternative medicine provides a potential possibility for demyelinating disease of the central nervous system (DDC) management and has been applied in considerable amounts of patients with this disorder. Nevertheless, powerful real-world evidences regarding the epidemiological and clinical characteristics, safety, and outcomes of TCM in DDC are lacking. The primary objective of the Demyelinating Diseases of the Central Nervous System Registry for Patients with Traditional Chinese Medicine (DATE-TCM) is to create an organized multicenter data collection structure to define integrative characteristics of DDC patients treated with TCM in an endeavor to fill these knowledge gaps to better inform clinical care and health policy.Method: This study provides a prospective and voluntary registry by using a web-based system. Baseline data will be recorded and subsequently regular follow-up visits will be implemented every 3–6 months for a total of 5 years. The primary outcome is Annualized Aggregate Relapse Rate at 5-year follow-up.Results: DATE-TCM is currently designed to capture the multidimensional (epidemiologic, demographic, clinical, etc.) features of DDC patients receiving TCM treatment, the type and long-term safety and efficacy of TCM intervenes in the DDC populations, as well as the interaction of TCM treatments and disease modifying therapies in the management of DDC, aiming to include 2000 eligible adult DDC patients with TCM intervenes from 35 participating centers, covering 77.4% of provincial administrative regions of mainland China.Conclusion: DATE-TCM is the first, largest, most geographically extensive, and standard registry-based observational study that systematically document the real-world data regarding the TCM application in the DDC populations, which will be extraordinarily important for clarifying the comprehensive characteristics and outcomes of TCM in DDC, further shed light on standardizing and optimizing the TCM measures for DDC management and establishing evidence-based clinical practice guidelines for TCM application in DDC.
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Debus JL, Bachmann P, Frahm N, Mashhadiakbar P, Langhorst SE, Streckenbach B, Baldt J, Heidler F, Hecker M, Zettl UK. Associated factors of potential drug-drug interactions and drug-food interactions in patients with multiple sclerosis. Ther Adv Chronic Dis 2022; 13:20406223221108391. [PMID: 35959503 PMCID: PMC9358348 DOI: 10.1177/20406223221108391] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 06/01/2022] [Indexed: 12/15/2022] Open
Abstract
Background: Multiple sclerosis (MS) is the most common immune-mediated demyelinating
disease in younger adults. Patients with MS (PwMS) are vulnerable to the
presence of potential drug–drug interactions (pDDIs) and potential drug–food
interactions (pDFIs) as they take numerous medications to treat MS,
associated symptoms and comorbidities. Knowledge about pDDIs and pDFIs can
increase treatment success and reduce side effects. Objective: We aimed at determining the frequency and severity of pDDIs and pDFIs in
PwMS, with regard to polypharmacy. Methods: In the cross-sectional study, we analysed pDDIs and pDFIs of 627 PwMS aged
⩾18 years. Data collection was performed through patient record reviews,
clinical examinations and structured patient interviews. pDDIs and pDFIs
were identified using two DDI databases: Drugs.com Interactions Checker and
Stockley’s Interactions Checker. Results: We identified 2587 pDDIs (counted with repetitions). Of 627 PwMS, 408 (65.1%)
had ⩾ 1 pDDI. Polypharmacy (concomitant use of ⩾ 5 drugs) was found for 334
patients (53.3%). Patients with polypharmacy (Pw/P) were found to have a
15-fold higher likelihood of having ⩾ 1 severe pDDI compared with patients
without polypharmacy (Pw/oP) (OR: 14.920, p < 0.001).
The most frequently recorded severe pDDI was between citalopram and
fingolimod. Regarding pDFIs, ibuprofen and alcohol was the most frequent
severe pDFI. Conclusion: Pw/P were particularly at risk of severe pDDIs. Age and educational level
were found to be factors associated with the occurrence of pDDIs,
independent of the number of medications taken. Screening for pDDIs/pDFIs
should be routinely done by the clinical physician to increase drug safety
and reduce side effects.
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Affiliation(s)
- Jane Louisa Debus
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Gehlsheimer Str. 20, 18147 Rostock, Germany
| | - Paula Bachmann
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
| | - Niklas Frahm
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
| | - Pegah Mashhadiakbar
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
| | - Silvan Elias Langhorst
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
| | - Barbara Streckenbach
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany; Department for Neurology, Ecumenic Hainich Hospital gGmbH, Mühlhausen, Germany
| | - Julia Baldt
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany; Department for Neurology, Ecumenic Hainich Hospital gGmbH, Mühlhausen, Germany
| | - Felicita Heidler
- Department for Neurology, Ecumenic Hainich Hospital gGmbH, Mühlhausen, Germany
| | - Michael Hecker
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
| | - Uwe Klaus Zettl
- Neuroimmunology Section, Department of Neurology, Rostock University Medical Centre, Rostock, Germany
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Frahm N, Hecker M, Zettl U. Polypharmacy in chronic neurological diseases: Multiple sclerosis, dementia and Parkinson's disease. Curr Pharm Des 2021; 27:4008-4016. [PMID: 34323180 DOI: 10.2174/1381612827666210728102832] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 07/02/2021] [Indexed: 11/22/2022]
Abstract
Polypharmacy is an important aspect of medication management and particularly affects elderly and chronically ill people. Patients with dementia, Parkinson's disease (PD) or multiple sclerosis (MS) are at high risk for multimedication due to their complex symptomatology. Our aim was to provide an overview of different definitions of polypharmacy and to present the current state of research on polypharmacy in patients with dementia, PD or MS. The most common definition of polypharmacy in the literature is the concomitant use of ≥5 medications (quantitative definition approach). Polypharmacy rates of up to >50% have been reported for patients with dementia, PD or MS, although MS patients are on average significantly younger than those with dementia or PD. The main predictor of polypharmacy is the complex symptom profile of these neurological disorders. Potentially inappropriate medication (PIM), drug-drug interactions, poor treatment adherence, severe disease course, cognitive impairment, hospitalisation, poor quality of life, frailty and mortality have been associated with polypharmacy in patients with dementia, PD or MS. For patients with polypharmacy, either the avoidance of PIM (selective deprescribing) or the substitution of PIM with more suitable drugs (appropriate polypharmacy) is recommended to achieve a more effective therapeutic management.
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Affiliation(s)
- Niklas Frahm
- Department of Neurology, Neuroimmunology Section, Rostock University Medical Center, Rostock, Germany
| | - Michael Hecker
- Department of Neurology, Neuroimmunology Section, Rostock University Medical Center, Rostock, Germany
| | - Uwe Zettl
- Department of Neurology, Neuroimmunology Section, Rostock University Medical Center, Rostock, Germany
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Alnahdi MA, Alsulayhim AK, Bin Salem AH, Masuadi E, Al Malik Y. Patterns and Outcomes of Complementary and Alternative Medicine Use Among Adult Patients With Multiple Sclerosis. Cureus 2020; 12:e10825. [PMID: 33173632 PMCID: PMC7645302 DOI: 10.7759/cureus.10825] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease that causes demyelination of the central nervous system. No treatment has been shown to be curative; thus, we assume that the tendency for patients with MS to use unconventional therapies, such as complementary and alternative medicine (CAM), might increase. The aim of this study was to explore the pattern of CAM use among patients with MS at a tertiary health care center in Saudi Arabia (SA). This was a questionnaire-based observational cross-sectional study that targeted adult patients diagnosed with MS at King Abdulaziz Medical City in Riyadh, SA, from 2018 to 2019. The sample size included 176 patients, and a consecutive non-probability sampling technique was used to engage them during their appointments. An Arabic questionnaire was used to evaluate patients' use of CAM. The mean age of participants was 34.6 ± 10.9 years, females represented the majority 125 (71%) of participants, and 89% of the participants reported using CAM at least once, with one or more modalities being used. Prayer, Salat, was the most frequent modality (60%) followed by supplication, Dua'a (59%), Ruqia, reciting Holy Quran (52%), and vitamins (44%). Symptomatic improvement was reported by 49 (27.8%) of dietary supplement users and 81 (46%) of non-dietary supplement medicine users. The study found a high prevalence of CAM utilization among Saudi adult patients with MS, which exceeded internationally reported rates. Although some patients described some improvement in their symptoms, further research is needed to evaluate the effectiveness of CAM.
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Affiliation(s)
- Muhannad A Alnahdi
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Abdullah K Alsulayhim
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Ahmed H Bin Salem
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Emad Masuadi
- Medical Education, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Statistician, King Abdullah International Medical Research Center, Riyadh, SAU
| | - Yaser Al Malik
- Medicine, College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Riyadh, SAU.,Medicine, King Abdullah International Medical Research Center, Riyadh, SAU.,Neurology, King Abdulaziz Medical City, National Guard - Health Affairs, Riyadh, SAU
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7
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Alphonsus KB, D'Arcy C. Factors Associated With Medication Use Among Individuals Living With Multiple Sclerosis. J Evid Based Integr Med 2020; 25:2515690X20936978. [PMID: 32618199 PMCID: PMC7491223 DOI: 10.1177/2515690x20936978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic autoimmune disease that affects the central nervous system causing neurological deterioration over time. The objective of this study was to examine the predictors associated with MS medication use. The categories that were investigated were various alternative treatments such as complementary/alternative medications (CAMs), rehabilitation therapy and psychotherapy services as well as comorbid health conditions. The Survey on Living with Neurological Conditions in Canada (SLNCC) 2011-2012 was used (N = 73 347) to carry out a logistic regression model. Individuals who did not take CAMs were more (OR = 5.44, 95% CI 1.37-9.29) likely to use medications for MS. Having a mood disorder was associated with greater use of MS medications (OR = 5.39, 95% CI 1.60-18.17) while back problems were associated with lower odds of medication use (OR = 0.38, 95% CI 0.15-0.98). These factors need to be taken into consideration when creating effective medication adherence interventions.
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Affiliation(s)
| | - Carl D'Arcy
- University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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8
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Bergien SO, Petersen CM, Lynning M, Kristiansen M, Skovgaard L. Use of natural medicine and dietary supplements concomitant with conventional medicine among people with Multiple Sclerosis. Mult Scler Relat Disord 2020; 44:102197. [PMID: 32531752 DOI: 10.1016/j.msard.2020.102197] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/05/2020] [Accepted: 05/11/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) are widespread among people with Multiple Sclerosis (PwMS) and are often used concomitant with conventional treatment. Natural medicine and dietary supplements (NADS) are the most frequently used CAM modality and among other patient groups use of NADS concomitant with conventional medicine has been reported as a potential risk to patients' safety due to risk of drug interactions. The use of NADS concomitant with conventional medicine has, however, not been investigated among PwMS. This study's aim was to investigate the prevalence of NADS and conventional MS-related medicine use among PwMS, specific types of NADS and conventional MS-related medicine used, the prevalence of NADS used concomitant with conventional MS-related medicine, and to characterize PwMS who use NADS and PwMS who use NADS concomitant with conventional MS-related medicine in a Danish context. METHODS The study was a cross-sectional study conducted as an interviewer-administered survey via phone in April 2019. The questionnaire includes questions about the use of NADS and conventional MS medicine as well as sociodemographic and health-related factors. In total 384 PwMS answered the questionnaire. Both descriptive and logistic analyses were used to analyze the data. RESULTS The results show that the majority of PwMS use conventional MS-related medicine. In total, 85 % (n=322) had used at least one NADS within the last 12 months including vitamin D. When excluding vitamin D, the use of NADS within the last 12 months was 78.4% (n=298). Beside vitamin D the most reported types of NADS used were fatty acids (37%), Multivitamins (37%), and Calcium (35%). A total of 75.8% (n=288) reported using NADS concomitant with conventional MS medicine, and the products most often combined with conventional MS medicine were Vitamin D, Multivitamin, Calcium, Magnesium, and fatty acids. The results suggest that PwMS using NADS concomitant with conventional MS-related medicine are characterized by a high prevalence of young and newly diagnosed patients with a high education level. CONCLUSION The study contributes to a better understanding of NADS used among PwMS. The study shows that the majority of PwMS use NADS and that they use it concomitant with conventional MS-medicine. Furthermore, the detailed mapping of the specific types of NADS used gives a nuanced insight into the specific products of NADS used among PwMS, including different kinds of vitamins, minerals, and herbal remedies.
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Affiliation(s)
- S O Bergien
- The Danish Multiple Sclerosis Society, Valby, Denmark.
| | - C M Petersen
- The Danish Multiple Sclerosis Society, Valby, Denmark
| | - M Lynning
- The Danish Multiple Sclerosis Society, Valby, Denmark
| | - M Kristiansen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - L Skovgaard
- The Danish Multiple Sclerosis Society, Valby, Denmark
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The effect of exercise, yoga and physiotherapy on the quality of life of people with multiple sclerosis: Systematic review and meta-analysis. Complement Ther Med 2019; 43:188-195. [DOI: 10.1016/j.ctim.2019.02.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/06/2019] [Accepted: 02/08/2019] [Indexed: 11/24/2022] Open
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10
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Rommer PS, König N, Sühnel A, Zettl UK. Coping behavior in multiple sclerosis-complementary and alternative medicine: A cross-sectional study. CNS Neurosci Ther 2018; 24:784-789. [PMID: 29635832 PMCID: PMC6120478 DOI: 10.1111/cns.12857] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 01/12/2018] [Accepted: 03/13/2018] [Indexed: 12/13/2022] Open
Abstract
Main Problem Treatment options for multiple sclerosis (MS) have enlarged tremendously over the last years. Nonetheless, lots of patients look for alternative treatment options. The use of complementary and alternative medicine (CAM) is widespread in MS, however, its scientific investigation is limited so far. The aim of the study is to analyse clinical and demographical differences of MS patients in dependency of their CAM utilization as coping strategy. Methods A total of 254 patients with a clinically definite MS were examined in a semistructured interview. Additional standardized questionnaires were used to measure different aspects of coping with illness. All patients underwent neurological examination. Results About 206 of all enrolled patients are CAM users (81.1%). They have a longer disease duration (8.3 years vs 7.3 years, P = 0.028) and show higher disability (median EDSS 4.0 vs 2.0, P < 0.001) than nonusers. CAM users differed significantly from nonusers in their coping behavior (P = 0.035). Users are brooding more heavily over the disease, looking for more information about MS, and are looking for a sense of their disease in religion more often than nonusers. CAM users are at a higher risk of depression. Almost two‐thirds of CAM users (57.6%) reported positive effects on the well‐being of their state of health. Conclusion Coping behavior differs significantly between CAM users and nonusers. CAM utilization is associated with higher disability and depression. More than 80% of our cohort has used alternative or complementary methods. CAM utilization may mirror unmet needs in the treatment of MS.
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Affiliation(s)
- Paulus S Rommer
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany.,Department of Neurology, Medical University of Vienna, Vienna, Austria
| | | | - Annett Sühnel
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
| | - Uwe K Zettl
- Department of Neurology, Neuroimmunological Section, University of Rostock, Rostock, Germany
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11
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Gotta M, Mayer CA, Huebner J. Use of complementary and alternative medicine in patients with multiple sclerosis in Germany. Complement Ther Med 2017; 36:113-117. [PMID: 29458916 DOI: 10.1016/j.ctim.2017.12.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 10/22/2017] [Accepted: 12/08/2017] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) for chronic diseases such as multiple sclerosis (MS) is becoming an increasingly important issue for those affected. Especially in Germany there are only a few studies dealing with CAM, as yet. The aim of this study was to assess the prevalence, the methods used, the subjective benefits as well as physician/patient communication. METHODS A structured questionnaire including demographic and disease-specific data, CAM use, perceived benefits as well as physician/patient communication was sent to real and web-based self-help groups for MS in Germany. RESULTS 343 answers could be evaluated. 77.3% of the participants were females. The mean age was 45.0 ± 11.9 years and the duration of the disease was 12.0 ± 9.6 years. 81.9% said they were using CAM, nearly half (44.8%) used it alternatively to conventional medicine. The average number of CAM- methods used were 3.6. The most popular methods were vitamin supplements, Yoga/Thai chi/Qi Gong, relaxation techniques and meditation. Approximately half (139/49.5%) of CAM users disclosed this to their treating neurologist. Yet, 37,6% have doubts on the competence of the respective physician. CONCLUSION Patients with MS have a strong interest in CAM. Usage as alternative therapy is widespread and puts patients at risk of progress of the disease. As patient/physician communication on the topic is increasing, neurologists should be attentive to guiding their patients through safe complementary methods.
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Affiliation(s)
- Mario Gotta
- Klinik für Innere Medizin II, Hämatologie und Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany.
| | - Christoph A Mayer
- Klinik für Neurologie, Johann Wolfgang Goethe Universität, Schleusenweg 2-16, 60528 Frankfurt am Main, Germany.
| | - Jutta Huebner
- Klinik für Innere Medizin II, Hämatologie und Onkologie, Universitätsklinikum Jena, Am Klinikum 1, 07747 Jena, Germany.
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12
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Campbell E, Coulter E, Mattison P, McFadyen A, Miller L, Paul L. Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey. Mult Scler Relat Disord 2017; 12:64-69. [DOI: 10.1016/j.msard.2017.01.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/16/2016] [Accepted: 01/04/2017] [Indexed: 10/20/2022]
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13
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Flamand-Roze C, Célestin-Lhopiteau I, Roze E. Hypnosis and movement disorders: State of the art and perspectives. Rev Neurol (Paris) 2016; 172:530-536. [DOI: 10.1016/j.neurol.2016.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 05/01/2016] [Accepted: 07/11/2016] [Indexed: 10/21/2022]
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Loraschi A, Bellantonio P, Bortolon F, Capra R, Cavalla P, Costantino G, Lugaresi A, Martinelli V, Marrosu MG, Patti F, Rottoli M, Salvetti M, Sola P, Solaro C, Klersy C, Marino F, Zaffaroni M, Cosentino M. Use of herbal remedies by multiple sclerosis patients: a nation-wide survey in Italy. Neurol Sci 2016; 37:613-22. [PMID: 26895323 DOI: 10.1007/s10072-016-2519-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 02/12/2016] [Indexed: 11/25/2022]
Abstract
Though recent progress in multiple sclerosis (MS) treatment is remarkable, numerous unmet needs remain to be addressed often inducing patients to look for complementary and alternative medicines (CAM), especially herbal remedies (HR). HR use, scarcely investigated in MS, may cause adverse reactions (AR) and interfere with conventional treatment. We performed a survey aimed at evaluating use and attitudes towards HR and factor associated to HR use. Other CAM use and attitudes have been investigated as well. Multiple-choice questionnaires were distributed to MS out patients attending 14 Italian referral Centers. Multivariable logistic regression was used to identify HR use determinants. Present/past HR use for either MS or other diseases was reported in 35.6 % of 2419 cases (95 % CI 36.0-40.0 %). CAM use was reported in 42.5 % of cases. Independent predictors of HR use were represented by higher education, geographic area, dissatisfaction with conventional treatment of diseases other than MS and benefit perception from CAM use. Both HR and CAM use were not always disclosed to the healthcare professional. In conclusion, HR and other CAM appear to be popular among MS patients. The involvement of the healthcare professionals appears to be scarce with potential risk of AR or interference with conventional treatments.
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Affiliation(s)
- A Loraschi
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy
| | - P Bellantonio
- Multiple Sclerosis Center, IRCCS Neuromed, Pozzilli, IS, Italy
| | - F Bortolon
- Multiple Sclerosis Centre, "San Bortolo" Hospital, Vicenza, Italy
| | - R Capra
- Multiple Sclerosis Center, Montichiari Hospital, Spedali Civili of Brescia, Brescia, Italy
| | - P Cavalla
- 1 Division of Neurology, Multiple Sclerosis Centre, A.O.U. City of Health and Science of Turin, Turin, Italy
| | - G Costantino
- Struttura Semplice "Sclerosi multipla" Az Ospedale-Università "Ospedali riuniti", Foggia, Italy
| | - A Lugaresi
- Department of Neuroscience, Imaging and Clinical Sciences, University G. d'Annunzio, Chieti, Italy
| | - V Martinelli
- Department of Neurology, San Raffaele Hospital, Milan, Italy
| | - M G Marrosu
- Department of Medical Sciences, University of Cagliari, Cagliari, Italy
| | - F Patti
- Department of Medical and Surgical Science and Advanced Technologies, GF Ingrassia, Neurosciences Section, Multiple Sclerosis Center, University of Catania, Catania, Italy
| | - M Rottoli
- Multiple Sclerosis Center of Bergamo, USS Malattie Autoimmuni, Azienda Ospedaliera Papa Giovanni XXIII of Bergamo, Piazza OMS 1, 24127, Bergamo, Italy
| | - M Salvetti
- Neurology and Department of Neurosciences, Mental Health and Sensory Organs, Centre for Experimental Neurological Therapies (CENTERS), Sapienza University of Rome, Rome, Italy
| | - P Sola
- Neurology Unit, Department of Neuroscience, University of Modena, Nuovo Ospedale Civile S. Agostino Estense, Estense, Italy
| | - C Solaro
- Neurology Unit, Department Head and Neck, ASL3 Genovese, Genoa, Italy
| | - C Klersy
- Biometry and Statistics Service, IRCCS Fondazione Policlinico S Matteo, Pavia, Italy
| | - F Marino
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy
| | - M Zaffaroni
- Multiple Sclerosis Center, Gallarate Hospital, Gallarate, Italy
| | - M Cosentino
- Center for Research in Medical Pharmacology, University of Insubria, Via Ottorino Rossi n. 9, 21100, Varese, VA, Italy.
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Narayanaswami P, Gronseth G, Dubinsky R, Penfold-Murray R, Cox J, Bever C, Martins Y, Rheaume C, Shouse D, Getchius TSD. The Impact of Social Media on Dissemination and Implementation of Clinical Practice Guidelines: A Longitudinal Observational Study. J Med Internet Res 2015; 17:e193. [PMID: 26272267 PMCID: PMC4736287 DOI: 10.2196/jmir.4414] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2015] [Revised: 07/15/2015] [Accepted: 07/16/2015] [Indexed: 11/30/2022] Open
Abstract
Background Evidence-based clinical practice guidelines (CPGs) are statements that provide recommendations to optimize patient care for a specific clinical problem or question. Merely reading a guideline rarely leads to implementation of recommendations. The American Academy of Neurology (AAN) has a formal process of guideline development and dissemination. The last few years have seen a burgeoning of social media such as Facebook, Twitter, and LinkedIn, and newer methods of dissemination such as podcasts and webinars. The role of these media in guideline dissemination has not been studied. Systematic evaluation of dissemination methods and comparison of the effectiveness of newer methods with traditional methods is not available. It is also not known whether specific dissemination methods may be more effectively targeted to specific audiences. Objective Our aim was to (1) develop an innovative dissemination strategy by adding social media-based dissemination methods to traditional methods for the AAN clinical practice guidelines “Complementary and alternative medicine in multiple sclerosis” (“CAM in MS”) and (2) evaluate whether the addition of social media outreach improves awareness of the CPG and knowledge of CPG recommendations, and affects implementation of those recommendations. Methods Outcomes were measured by four surveys in each of the two target populations: patients and physicians/clinicians (“physicians”). The primary outcome was the difference in participants’ intent to discuss use of complementary and alternative medicine (CAM) with their physicians or patients, respectively, after novel dissemination, as compared with that after traditional dissemination. Secondary outcomes were changes in awareness of the CPG, knowledge of CPG content, and behavior regarding CAM use in multiple sclerosis (MS). Results Response rates were 25.08% (622/2480) for physicians and 43.5% (348/800) for patients. Awareness of the CPG increased after traditional dissemination (absolute difference, 95% confidence interval: physicians 36%, 95% CI 25-46, and patients 10%, 95% CI 1-11) but did not increase further after novel dissemination (physicians 0%, 95% CI -11 to 11, and patients -4%, 95% CI -6 to 14). Intent to discuss CAM also increased after traditional dissemination but did not change after novel dissemination (traditional: physicians 12%, 95% CI 2-22, and patients 19%, 95% CI 3-33; novel: physicians 11%, 95% CI -1 to -21, and patients -8%, 95% CI -22 to 8). Knowledge of CPG recommendations and behavior regarding CAM use in MS did not change after either traditional dissemination or novel dissemination. Conclusions Social media-based dissemination methods did not confer additional benefit over print-, email-, and Internet-based methods in increasing CPG awareness and changing intent in physicians or patients. Research on audience selection, message formatting, and message delivery is required to utilize Web 2.0 technologies optimally for dissemination.
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Affiliation(s)
- Pushpa Narayanaswami
- Beth Israel Deaconess Medical Center, Department of Neurology, Harvard Medical school, Boston, MA, United States.
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Complementary and Alternative Medical Therapies in Multiple Sclerosis–The American Academy of Neurology Guidelines: A Commentary. Clin Ther 2014; 36:1972-1978. [DOI: 10.1016/j.clinthera.2014.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2014] [Accepted: 10/10/2014] [Indexed: 02/07/2023]
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Changes in attitudes toward and patterns in traditional Korean medicine among the general population in South Korea: a comparison between 2008 and 2011. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:436. [PMID: 25380563 PMCID: PMC4233081 DOI: 10.1186/1472-6882-14-436] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/08/2014] [Accepted: 10/29/2014] [Indexed: 12/05/2022]
Abstract
Background Traditional Korean medicine (TKM) is acknowledged to be prevalent among the Korean public, but few follow-up studies are available to confirm this commonly held belief. Whereas most survey studies have focused on the demographic factors influencing the usage of TKM, only a few studies have conducted a pattern or trend analysis over time. The purpose of this paper is to observe and document recent trends in the usage of TKM in South Korea and to compare overall patterns of TKM use over a period of several years. Methods A cross-sectional survey was conducted in 2011 to assess TKM usage patterns and public perceptions regarding TKM. An online questionnaire was administered to consenting respondents that focused upon individual preferences between TKM and current Western medicine, respondents’ reasons for using TKM, the frequency of respondents’ visits to TKM clinics, the reasons respondents visited TKM clinics, and respondents’ perceived satisfaction. Results The results revealed that 66.6% of the respondents showed a positive attitude toward TKM. In addition, 69.3% of the respondents had visited TKM clinics one to four times during the previous year. Patients used TKM with the intentions of receiving acupuncture (95.3%), moxibustion (40.1%), and cupping (36.0%) treatments or to take herbal medicines (35.7%). Most respondents who had visited TKM clinics were largely satisfied with the clinics’ effectiveness (56.1%). The factors most commonly associated with TKM usage included sex (female), age (50s), and education (college or higher), but the within-factor differences were not significant. Compared with a previous survey of other groups, TKM usage was found to have increased from 45.8% in 2008 to 69.3% in 2011. With the exception of acupuncture and physical therapy, most usage doubled or more than doubled. Conclusions The attitudes toward and usage of TKM in South Korea have improved between 2008 and 2011. This result will be used to explain outcomes of certain social phenomena and to argue for national support in the promotion of TKM. Electronic supplementary material The online version of this article (doi:10.1186/1472-6882-14-436) contains supplementary material, which is available to authorized users.
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Buchanan PA, Nelsen NL, Geletta S. United States Guild Certified Feldenkrais Teachers®: a survey of characteristics and practice patterns. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 14:217. [PMID: 24985488 PMCID: PMC4086994 DOI: 10.1186/1472-6882-14-217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 06/25/2014] [Indexed: 11/30/2022]
Abstract
Background Feldenkrais Method® teachers help students improve function and quality of life through verbally and manually guided lessons. The reasons people seek Feldenkrais® lessons are poorly understood. Similarly, little is known about practice characteristics and patterns. To address these knowledge gaps, we conducted an extensive survey of United States Guild Certified Feldenkrais Teachers®. Methods We invited all Feldenkrais Teachers to participate in this survey delivered in web-based or print formats. We obtained overall and question-specific response rates, descriptive statistics, chi-square tests of response bias, and performed qualitative thematic review of comments. Results Overall response rate was 30.5% (392/1287). Ninety percent of responders had college degrees in diverse fields; 12.5% had credentials outside health care, 36.9% held conventional health care licenses, and 23.1% had complementary and alternative medicine credentials. Mean age was 55.7 years; most teachers were women (83%). California (n = 100) and New York (n = 34) had the most teachers. Forty-five percent of teachers earned ≤ 20% of their gross income from their practices, while 26% earned > 80%. Most saw < 10 students/week for individual lessons and < 10 students/week for group lessons. Students were mostly women (71.1%) and 45–64 years old. The primary reason students sought Feldenkrais lessons was pain. A quarter of students self-referred, a fifth were referred by conventional health care providers, and two-thirds paid for services directly. Themes from comments included: beliefs that Feldenkrais training had important personal and professional benefits for teachers; recognition of the challenges of operating small businesses and succinctly describing the Feldenkrais Method; the variety of practice approaches; and a deep commitment to the Feldenkrais Method. Conclusions Most Feldenkrais Teachers were well educated, often held additional credentials, were located in the West, were women, were older than 50 years, and had part-time practices. Most students were women, were adults, came from various referral sources, and paid directly for services. Teachers and students utilized the Feldenkrais Method in diverse settings and applications. These findings may foster practice development by Feldenkrais Teachers, improve communication between health care consumers and providers and assist decision-making, and stimulate more research concerning the Feldenkrais Method.
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Masullo L, Papas MA, Cotugna N, Baker S, Mahoney L, Trabulsi J. Complementary and Alternative Medicine Use and Nutrient Intake Among Individuals with Multiple Sclerosis in the United States. J Community Health 2014; 40:153-60. [DOI: 10.1007/s10900-014-9913-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yadav V, Bever C, Bowen J, Bowling A, Weinstock-Guttman B, Cameron M, Bourdette D, Gronseth GS, Narayanaswami P. Summary of evidence-based guideline: complementary and alternative medicine in multiple sclerosis: report of the guideline development subcommittee of the American Academy of Neurology. Neurology 2014; 82:1083-92. [PMID: 24663230 DOI: 10.1212/wnl.0000000000000250] [Citation(s) in RCA: 126] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To develop evidence-based recommendations for complementary and alternative medicine (CAM) in multiple sclerosis (MS). METHODS We searched the literature (1970-March 2011; March 2011-September 2013 MEDLINE search), classified articles, and linked recommendations to evidence. RESULTS AND RECOMMENDATIONS Clinicians might offer oral cannabis extract for spasticity symptoms and pain (excluding central neuropathic pain) (Level A). Clinicians might offer tetrahydrocannabinol for spasticity symptoms and pain (excluding central neuropathic pain) (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity (short-term)/tremor (Level B) and possibly effective for spasticity and pain (long-term) (Level C). Clinicians might offer Sativex oromucosal cannabinoid spray (nabiximols) for spasticity symptoms, pain, and urinary frequency (Level B). Clinicians should counsel patients that these agents are probably ineffective for objective spasticity/urinary incontinence (Level B). Clinicians might choose not to offer these agents for tremor (Level C). Clinicians might counsel patients that magnetic therapy is probably effective for fatigue and probably ineffective for depression (Level B); fish oil is probably ineffective for relapses, disability, fatigue, MRI lesions, and quality of life (QOL) (Level B); ginkgo biloba is ineffective for cognition (Level A) and possibly effective for fatigue (Level C); reflexology is possibly effective for paresthesia (Level C); Cari Loder regimen is possibly ineffective for disability, symptoms, depression, and fatigue (Level C); and bee sting therapy is possibly ineffective for relapses, disability, fatigue, lesion burden/volume, and health-related QOL (Level C). Cannabinoids may cause adverse effects. Clinicians should exercise caution regarding standardized vs nonstandardized cannabis extracts and overall CAM quality control/nonregulation. Safety/efficacy of other CAM/CAM interaction with MS disease-modifying therapies is unknown.
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Affiliation(s)
- Vijayshree Yadav
- From the Department of Neurology (V.Y., M.C., D.B.), Oregon Health & Science University and Department of Neurology (V.Y., M.C., D.B.), Veterans Affairs Medical Center, Portland; MS Center of Excellence-East (C.B.), VA Maryland Health Care System and Department of Neurology (C.B.), University of Maryland School of Medicine, Baltimore; Multiple Sclerosis Center (J.B.), Swedish Neuroscience Institute, Seattle, WA; Multiple Sclerosis Service and Complementary and Alternative Medicine Service (A.B.), Colorado Neurological Institute, Englewood; The Jacobs Neurological Institute (B.W.-G.), Buffalo, NY; Department of Neurology (G.S.G.), University of Kansas Medical Center, Kansas City, KS; and Department of Neurology (P.N.), Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA
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Skovgaard L, Pedersen IK, Verhoef M. Use of bodily sensations as a risk assessment tool: exploring people with Multiple Sclerosis' views on risks of negative interactions between herbal medicine and conventional drug therapies. Altern Ther Health Med 2014; 14:59. [PMID: 24533750 PMCID: PMC3942187 DOI: 10.1186/1472-6882-14-59] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2013] [Accepted: 01/12/2014] [Indexed: 12/01/2022]
Abstract
Background Most users of complementary and alternative medicine (CAM) combine it with conventional medicine. Recent risk assessment studies have shown risks of negative interactions between CAM and conventional medicine, particularly when combining herbal medicine and conventional drug therapies (CDT). Little is known about the way users consider such risks. The present paper aims to gain knowledge about this issue by exploring views on risks of negative interactions when combining herbal medicine and CDT among people with multiple sclerosis (MS). Methods This paper draws on a qualitative follow-up study on a survey among members of the Danish MS Society. Semi-structured, in-depth qualitative interviews were conducted with a strategic selection from the survey respondents. The study was inspired by a phenomenological approach and emerging themes were extracted from the data through meaning condensation. Results Four themes characterized the informants’ views on risks of negative interactions when combining herbal medicine and CDT: 1) ‘naturalness’ in herbal medicine; 2) ‘bodily sensations’ as guidelines; 3) trust in the CAM practitioner; 4) lack of dialogue with medical doctor. Conclusions Generally, the combination of herbal medicine and CDT was considered by the informants to be safe. In particular, they emphasized the ‘non-chemical’ nature of herbal medicine and of their own bodily sensations as warrants of safety. A trustful relation to the CAM practitioner furthermore made some of them feel safe in their use of herbal medicine and CDT in combination. The informants’ use of bodily sensations as a non-discursive risk assessment may be a relevant element in understanding these issues.
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Kochs L, Wegener S, Sühnel A, Voigt K, Zettl UK. The use of complementary and alternative medicine in patients with multiple sclerosis: A longitudinal study. Complement Ther Med 2014; 22:166-72. [DOI: 10.1016/j.ctim.2013.11.006] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2013] [Revised: 11/08/2013] [Accepted: 11/21/2013] [Indexed: 11/17/2022] Open
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Skovgaard L, Nicolajsen P, Pedersen E, Kant M, Fredrikson S, Verhoef M, Meyrowitsch D. People with multiple sclerosis in Denmark who use complementary and alternative medicine—Do subgroups of patients differ? Eur J Integr Med 2013. [DOI: 10.1016/j.eujim.2013.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Skovgaard L, Nicolajsen PH, Pedersen E, Kant M, Fredrikson S, Verhoef M, Meyrowitsch D. Differences between users and non-users of complementary and alternative medicine among people with multiple sclerosis in Denmark: a comparison of descriptive characteristics. Scand J Public Health 2013; 41:492-9. [PMID: 23548494 DOI: 10.1177/1403494813481646] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
AIMS The aim of this study was to investigate differences in socio-economic characteristics between CAM users and CAM non-users among people with MS in Denmark as well as differences in characteristics related to the use of CAM among CAM users and the use of conventional treatments among CAM non-users. METHODS An internet-based questionnaire was used to collect data from 3361 patient members of the Danish MS society. A letter with a personal code was sent to all respondents, asking them to fill out the questionnaire online. Reminders to non-respondents were sent twice and the final response rate was 55.5%. Statistical associations were presented as odds ratios and with respective 95% confidence intervals. RESULTS People with MS in Denmark use a wide range of CAM treatments for a variety of reasons. CAM users were more likely to be of female gender, 18-40 years of age, educated at bachelor level or above, and have a high income compared to CAM non-users (p < 0.05). CAM users more often addressed non-specific/preventive treatment purposes through their use of CAM treatments, they communicated less often with a medical doctor about the CAM treatments used, and they experienced less side effects as well as less positive effects from the CAM treatments used when compared with the use of conventional treatments among CAM non-users (p < 0.05). CONCLUSIONS People with MS in Denmark reported use of a large range of CAM treatments. CAM users differed from CAN non-users in relation to socio-economic factors as well as treatment characteristics.
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Affiliation(s)
- Lasse Skovgaard
- Department of Public Health, University of Copenhagen, Denmark. lsk@ scleroseforeningen.dk
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Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries. Autoimmune Dis 2012; 2012:841085. [PMID: 23304461 PMCID: PMC3529905 DOI: 10.1155/2012/841085] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2012] [Revised: 09/22/2012] [Accepted: 09/22/2012] [Indexed: 11/17/2022] Open
Abstract
Aims. The aim of the study was to describe and compare (1) the types and prevalence of complementary and alternative medicine (CAM) treatments used among individuals with multiple sclerosis (MS) in the Nordic countries; (2) the types of conventional treatments besides disease-modifying medicine for MS that were used in combination with CAM treatments; (3) the types of symptoms/health issues addressed by use of CAM treatments. Methods. An internet-based questionnaire was used to collect data from 6455 members of the five Nordic MS societies. The response rates varied from 50.9% in Norway to 61.5% in Iceland. Results. A large range of CAM treatments were reported to be in use in all five Nordic countries. Supplements of vitamins and minerals, supplements of oils, special diet, acupuncture, and herbal medicine were among the CAM treatment modalities most commonly used. The prevalence of the overall use of CAM treatments within the last twelve months varied from 46.0% in Sweden to 58.9% in Iceland. CAM treatments were most often used in combination with conventional treatments. The conventional treatments that were most often combined with CAM treatment were prescription medication, physical therapy, and over-the-counter (OTC) medications. The proportion of CAM users who reported exclusive use of CAM (defined as use of no conventional treatments besides disease-modifying medicine for MS) varied from 9.5% in Finland to 18.4% in Norway. In all five Nordic countries, CAM treatments were most commonly used for nonspecific/preventative purposes such as strengthening the body in general, improving the body's muscle strength, and improving well-being. CAM treatments were less often used for the purpose of improving specific symptoms such as body pain, problems with balance, and fatigue/lack of energy. Conclusions. A large range of CAM treatments were used by individuals with MS in all Nordic countries. The most commonly reported rationale for CAM treatment use focused on improving the general state of health. The overall pattern of CAM treatment use was similar across the five countries.
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Salamonsen A, Drageset BJ, Fønnebø V. A Patient-defined "Best Case" of Multiple Sclerosis Related to the Use of Complementary and Alternative Medicine. Glob Adv Health Med 2012; 1:32-4. [PMID: 24278800 PMCID: PMC3833471 DOI: 10.7453/gahmj.2012.1.1.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Chronically ill people are frequent users of complementary and alternative medicine (CAM). Some patients experience great benefits from their use of CAM, like patient “XX” in this case report. XX was diagnosed with secondary progressive multiple sclerosis in 2004 and has reported a “best case” after the use of Dr Birgitta Brunes' unconventional treatment. The patient reports that many of her symptoms that, according to her neurologist, were irreversible are gone or have been greatly reduced. Such patient-defined “best cases” related to the use of CAM should be further explored to optimize and safeguard patients' treatment decisions and treatment outcomes.
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Affiliation(s)
- Anita Salamonsen
- Anita Salamonsen, MSc, is a researcher of The National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, University of Tromsø, Norway
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Hydrotherapy for the treatment of pain in people with multiple sclerosis: a randomized controlled trial. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2011; 2012:473963. [PMID: 21785645 PMCID: PMC3138085 DOI: 10.1155/2012/473963] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/10/2011] [Revised: 05/08/2011] [Accepted: 05/16/2011] [Indexed: 11/18/2022]
Abstract
Background. Multiple sclerosis (MS) is a chronic demyelinating neurological disease. Several studies have reported that complementary and alternative therapies can have positive effects against pain in these patients. Objective. The objective was to investigate the effectiveness of an Ai-Chi aquatic exercise program against pain and other symptoms in MS patients. Methods. In this randomized controlled trial, 73 MS patients were randomly assigned to an experimental or control group for a 20-week treatment program. The experimental group underwent 40 sessions of Ai-Chi exercise in swimming pool and the control group 40 sessions of abdominal breathing and contraction-relaxation exercises in therapy room. Outcome variables were pain, disability, spasm, depression, fatigue, and autonomy, which were assessed before the intervention and immediately and at 4 and 10 weeks after the last treatment session. Results. The experimental group showed a significant (P < 0.028) and clinically relevant decrease in pain intensity versus baseline, with an immediate posttreatment reduction in median visual analogue scale scores of 50% that was maintained for up to 10 weeks. Significant improvements were also observed in spasm, fatigue, disability, and autonomy. Conclusion. According to these findings, an Ai-Chi aquatic exercise program improves pain, spasms, disability, fatigue, depression, and autonomy in MS patients.
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Lökk J, Nilsson M. Frequency, type and factors associated with the use of complementary and alternative medicine in patients with Parkinson’s disease at a neurological outpatient clinic. Parkinsonism Relat Disord 2010; 16:540-4. [PMID: 20655794 DOI: 10.1016/j.parkreldis.2010.06.007] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2010] [Revised: 06/10/2010] [Accepted: 06/11/2010] [Indexed: 11/17/2022]
Affiliation(s)
- Johan Lökk
- Institution of Neurobiology, Care Sciences and Society, Karolinska Institutet, Geriatric Dept, Karolinska University Hospital Huddinge, SE-14186 Stockholm, Sweden.
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Salamonsen A, Launsø L, Kruse TE, Eriksen SH. Understanding unexpected courses of multiple sclerosis among patients using complementary and alternative medicine: A travel from recipient to explorer. Int J Qual Stud Health Well-being 2010; 5:10.3402/qhw.v5i2.5032. [PMID: 20616888 PMCID: PMC2900149 DOI: 10.3402/qhw.v5i2.5032] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2010] [Indexed: 12/31/2022] Open
Abstract
Complementary and alternative medicine (CAM) is frequently used by patients with multiple sclerosis (MS). Some MS patients experience unexpected improvements of symptoms, which they relate to their use of CAM. The aim of this study was to obtain knowledge and develop understandings of such self-defined unexpected improvement of MS symptoms. Two cases were constructed based on documents and 12 qualitative interviews. Our aim was not to make generalisations from the cases, but to transfer knowledge as working hypotheses. We identified four health-related change processes: the process of losing bodily competence; the process of developing responsibility; the process of taking control; and the process of choosing CAM. The patients explained unexpected improvements in their MS symptoms as results of their own efforts including their choice and use of CAM. In our theoretical interpretations, we found the patients' redefinition of history, the concept of treatment and the importance of conventional health care to be essential, and leading to a change of patients' position towards conventional health care from recipients to explorers. The explorers can be perceived as boundary walkers reflecting limitations within the conventional health care system and as initiators regarding what MS patients find useful in CAM.
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Affiliation(s)
- Anita Salamonsen
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, University of Tromsø, Tromsø, Norway
- Department of Sociology, Political Science and Community Planning, University of Tromsø, Tromsø, Norway
| | - Laila Launsø
- National Research Center in Complementary and Alternative Medicine (NAFKAM), Department of Community Medicine, University of Tromsø, Tromsø, Norway
| | - Tove E. Kruse
- Department of Culture and Identity, Roskilde University, Roskilde, Denmark
| | - Sissel H. Eriksen
- Department of Sociology, Political Science and Community Planning, University of Tromsø, Tromsø, Norway
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Complementary and alternative medicines and dietary interventions in multiple sclerosis: What is being used in South Australia and why? Complement Ther Med 2009; 17:216-23. [DOI: 10.1016/j.ctim.2009.03.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Revised: 01/23/2009] [Accepted: 03/19/2009] [Indexed: 11/17/2022] Open
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Olsen SA. A review of complementary and alternative medicine (CAM) by people with multiple sclerosis. Occup Ther Int 2009; 16:57-70. [PMID: 19222053 DOI: 10.1002/oti.266] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Multiple sclerosis (MS) is a chronic, unpredictable disease of the central nervous system without a known cure. Because of this, people with MS often seek complementary and alternative medicines (CAM) to manage their disease symptoms. The goal of this review article was to describe the use of CAM by individuals diagnosed with MS. Evidence was obtained by searching Medline (1950-2007), EBSCOhost and PubMed for studies relating CAM to MS. Results from the literature showed that people with MS reported that they used CAM from 27 to 100%. The major reasons for choosing CAM were as follows: conventional treatment was not effective, anecdotal reports of CAM's help, and doctor referral. The types of CAM reported by people with MS included exercise, vitamins, herbal and mineral supplements, relaxation techniques, acupuncture, cannabis and massage. The major symptoms treated by CAM as noted in the literature were pain, fatigue and stress. There is a need for further research to evaluate the effectiveness of CAM with MS patients and their application by occupational therapists. The limitation of this literature review was the low response rate in many of the surveys reported.
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Affiliation(s)
- Sherri A Olsen
- MultiCare Health Systems, 315 Martin Luther King Jr. Way, Tacoma, WA. olsenls1515msn.com
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Kim SR, Lee TY, Kim MS, Lee MC, Chung SJ. Use of complementary and alternative medicine by Korean patients with Parkinson's disease. Clin Neurol Neurosurg 2009; 111:156-60. [PMID: 18977584 DOI: 10.1016/j.clineuro.2008.09.011] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2008] [Revised: 09/04/2008] [Accepted: 09/04/2008] [Indexed: 10/21/2022]
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Murphy SM, Rogers A, Hutchinson M, Tubridy N. Counting the cost of complementary and alternative therapies in an Irish neurological clinic. Eur J Neurol 2008; 15:1380-3. [DOI: 10.1111/j.1468-1331.2008.02320.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Schwarz S, Knorr C, Geiger H, Flachenecker P. Complementary and alternative medicine for multiple sclerosis. Mult Scler 2008; 14:1113-9. [DOI: 10.1177/1352458508092808] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
We analyzed characteristics, motivation, and effectiveness of complementary and alternative medicine in a large sample of people with multiple sclerosis. A 53-item survey was mailed to the members of the German Multiple Sclerosis Society, chapter of Baden-Wuerttemberg. Surveys of 1573 patients (48.5 ± 11.7 years, 74% women, duration of illness 18.1 ± 10.5 years) were analyzed. In comparison with conventional medicine, more patients displayed a positive attitude toward complementary and alternative medicine (44% vs 38%, P < 0.05), with 70% reporting lifetime use of at least one method. Among a wide variety of complementary and alternative medicine, diet modification (41%), Omega-3 fatty acids (37%), removal of amalgam fillings (28%), vitamins E (28%), B (36%), and C (28%), homeopathy (26%), and selenium (24%) were cited most frequently. Most respondents (69%) were satisfied with the effects of complementary and alternative medicine. Use of complementary and alternative medicine was associated with religiosity, functional independence, female sex, white-collar job, and higher education ( P < 0.05). Compared with conventional therapies, complementary and alternative medicine rarely showed unwanted side effects (9% vs 59%, P < 0.00001). A total of 52% stated that the initial consultation with their physician lasted less than 15 min. To conclude, main reasons for the use of complementary and alternative medicine include the high rate of side effects and low levels of satisfaction with conventional treatments and brief patients/physicians contacts.
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Affiliation(s)
- S Schwarz
- Central Institute of Mental Health, University of Heidelberg, J 5, Mannheim 68159, Germany; Department of Neurology, Klinikum Mannheim, University of Heidelberg, Theodor-Kutzer-Ufer 1- 3, Mannheim 68167, Germany
| | - C Knorr
- Central Institute of Mental Health, University of Heidelberg, J 5, Mannheim 68159, Germany
| | - H Geiger
- AMSEL Baden-Wuerttemberg, Regerstrasse 18, Stuttgart 70071, Germany
| | - P Flachenecker
- Neurological Rehabilitation Center "Quellenhof", Kuranlagenallee 2, Bad Wildbad 75323, Germany
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Hensel M, Zoz M, Ho AD. Complementary and alternative medicine in patients with chronic lymphocytic leukemia. Support Care Cancer 2008; 17:47-52. [DOI: 10.1007/s00520-008-0452-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2008] [Accepted: 04/03/2008] [Indexed: 11/24/2022]
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Apel A, Greim B, Zettl UK. Complementary and alternative medicine and coping in neuroimmunological diseases. J Neurol 2007; 254 Suppl 2:II112-5. [PMID: 17503118 DOI: 10.1007/s00415-007-2027-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The utilisation of complementary and alternative medicine (CAM) is widespread in neuroimmunological diseases like multiple sclerosis (MS) but has been disregarded in research until lately. After describing the problems of definition in CAM, different categories will be described. Various confounding factors on CAM utilisation exist, though hardly investigated. Besides sociodemographic variables like education, income, gender and age, illness-related factors like severity of disease are discussed. Furthermore, the important role of coping and CAM utilisation has not been investigated in neuroimmunological diseases, yet. Results derived from our investigations on CAM utilisation in MS indicate that users of CAM apply coping strategies, such as "rumination", "search for information" and "search for meaning in religion", more frequently than non-users and that current CAM utilisation is related to depression. Further research is needed in this field, as well as in other neuroimmunological diseases.
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Affiliation(s)
- A Apel
- Dept. of Neurology, University of Rostock, Gehlsheimer Str. 20, 18147, Rostock, Germany.
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