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Yi EHG, Jang Y, Liang J. Utilization of Traditional Complementary and Alternative Medicine Across Ethnically Diverse Asian Americans. J Immigr Minor Health 2024; 26:527-538. [PMID: 38334856 DOI: 10.1007/s10903-024-01583-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2024] [Indexed: 02/10/2024]
Abstract
We conducted an analysis to identify factors influencing the use of traditional complementary and alternative medicine (TCAM), with a particular emphasis on ethnic variations. Using the 2015 Asian American Quality of Life survey (N = 2,609), logistic regression analyses were performed, considering acculturation, health status, healthcare accessibility/utilization, and socio-demographic factors. Ethnicity, specifically being Chinese or Korean Americans, having chronic medical conditions, experiencing unmet healthcare needs, and having regular check-ups were significant predictors of TCAM use among Asian Americans as a whole. However, when we delved into sub-ethnic groups, different patterns were found. Among Vietnamese and Filipino Americans, having unmet healthcare needs emerged as the most prominent predictor of TCAM use. Furthermore, acculturation level and English proficiency were significant in predicting Vietnamese and Filipino Americans' TCAM use, with the direction varying by sub-ethnicity. Being old emerged as a predictor of TCAM use for Chinese, Indian, Korean, and 'other' Americans. Our findings underscore the importance of adopting an ethnically sensitive approach when addressing the healthcare needs of diverse Asian American populations.
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Affiliation(s)
- Eun-Hye Grace Yi
- Department of Social Work, California State University, Fullerton, CA, USA.
| | - Yuri Jang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Jiaming Liang
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
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Li R, Sidawy A, Nguyen BN. Comparative assessment of racial disparity in 30-day outcomes for Asian Americans undergoing carotid endarterectomy. J Vasc Surg 2024; 79:1132-1141. [PMID: 38142944 DOI: 10.1016/j.jvs.2023.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/29/2023] [Accepted: 12/19/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE Carotid endarterectomy (CEA) is an effective treatment for carotid stenosis. All previous studies on racial disparity of CEA outcomes omitted Asian Americans. This study aimed to address this gap by investigating racial disparities in 30-day outcomes following CEA among Asian Americans. METHODS Asian American and Caucasian patients who underwent CEA were identified in the American College of Surgeons National Surgical Quality Improvement Program targeted database from 2011 to 2021. Patients with age less than 18 years old were excluded. Patients with symptomatic and asymptomatic carotid stenosis were examined separately. A 1:5 propensity-score matching was used to address preoperative differences. Thirty perioperative outcomes were assessed. RESULTS There were 380 Asian Americans (2.27%) and 13,250 Caucasians (79.18%) with symptomatic carotid stenosis who underwent CEA. Also, 289 Asian Americans (1.40%) and 18,257 Caucasians (88.14%) with asymptomatic carotid stenosis had CEA. Asian Americans undergoing CEA presented with higher comorbid burdens and more severe symptomology. Also, asymptomatic Asian Americans were more likely to undergo surgeries for mild stenosis (<50%), which is not in line with practice guidelines. After 1:5 propensity-matching, all symptomatic Asian Americans were matched to 1550 Caucasian patients, and all asymptomatic Asian Americans were matched to 1445 Caucasians; preoperative differences were addressed. Asian Americans exhibited low overall 30-day mortality (symptomatic, 1.61%; asymptomatic, 0.35%) and stroke (symptomatic, 2.26%; asymptomatic, 0.69%). All perioperative outcomes were comparable to Caucasians, with the exception that Asian Americans experienced longer operation times. CONCLUSIONS Evidence suggested that Asian Americans with asymptomatic stenosis were underrepresented in CEA. After propensity-score matching, Asian Americans demonstrated comparable 30-day outcomes to Caucasians. These suggest that, when afforded equal access to quality health care, CEA serves as an effective treatment for carotid stenosis among Asian Americans. Therefore, efforts may be aimed at addressing health care access, potentially in the screening for asymptomatic carotid stenosis in Asian Americans. This would ensure they have equitable benefits from CEA. Nevertheless, the exact preoperative differences and long-term CEA outcomes in Asian Americans should warrant further examination in future studies.
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Affiliation(s)
- Renxi Li
- The George Washington University School of Medicine and Health Sciences, Washington, DC.
| | - Anton Sidawy
- The George Washington University Hospital, Department of Surgery, Washington, DC
| | - Bao-Ngoc Nguyen
- The George Washington University Hospital, Department of Surgery, Washington, DC
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Li R, Luo Q, Yanavitski M, Huddleston SJ. Disparity among Asian Americans in transcatheter and surgical aortic valve replacement. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2024; 59:84-90. [PMID: 37673721 DOI: 10.1016/j.carrev.2023.08.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 08/30/2023] [Accepted: 08/30/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Racial disparities in transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR) outcomes have been established, but research has predominantly focused on African Americans and Hispanics, leaving a gap in Asian Americans. This study aimed to investigate disparities in aortic valve replacement outcomes among Asian Americans. METHODS Patients who underwent SAVR and TAVR were identified in National Inpatient Sample from the last quarter of 2015-2020. A 1:2 propensity score matching was applied to Asian Americans and Caucasians. In-hospital perioperative outcomes, length of stay, days from admission to operation, and total hospital charge, were compared. RESULTS In TAVR, 51,394 (84.41 %) were Caucasians and 795 (1.31 %) were Asian Americans. In SAVR, there were 50,080 (78.52 %) Caucasians and 1233 (1.93 %) Asian Americans. No significant difference was found in post-TAVR complications. However, Asian Americans experienced longer waiting time until operation (p = 0.03) and higher costs (p < 0.01) in TAVR. In SAVR, Asian Americans had higher risks of in-hospital mortality (3.91 % vs 2.39 %, p = 0.01), cardiogenic shock (8.71 % vs 6.74 %, p = 0.03), respiratory complications (14.08 % vs 11.2 %, p = 0.01), mechanical ventilation (13.83 % vs 9.09 %, p < 0.01), acute kidney injury (25.47 % vs 20.13 %, p < 0.01), and hemorrhage/hematoma (72.01 % vs 62.95 %, p < 0.01). Additionally, Asian Americans underwent SAVR had longer lengths of stay (p < 0.01) and higher costs (p < 0.01). CONCLUSIONS Asian Americans were underrepresented in aortic valve replacement. Asian Americans, while having similar post-TAVR outcomes to Caucasians, faced greater risks of post-SAVR mortality and surgical complications. These disparities among Asian Americans call for targeted actions to ensure equitable health outcomes.
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Affiliation(s)
- Renxi Li
- The George Washington University School of Medicine and Health Sciences, Washington, DC, United States of America; Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America.
| | - Qianyun Luo
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America
| | - Marat Yanavitski
- M Health University of Minnesota Physicians, Cardiology East Division, Minneapolis, MN, United States of America
| | - Stephen J Huddleston
- Division of Cardiovascular and Thoracic Surgery, Department of Surgery, University of Minnesota Medical School, Minneapolis, MN, United States of America
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Abusanad A, Ujaimi R, Alotaibi MA, Alharbi LA, Alatawi N, Algarni AA, Samkari A. Exploring Integrative Approaches: Insights Into Complementary Medicine Practices Among Breast Cancer Survivors in Saudi Arabia. Cureus 2024; 16:e52282. [PMID: 38357079 PMCID: PMC10865160 DOI: 10.7759/cureus.52282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
OBJECTIVES Complementary and integrative medicine (CAM) is a prevalent approach often used with conventional medical practices The study aims to understand the factors influencing breast cancer (BC) survivors' decisions regarding CAM therapy and the drivers behind their use. SETTING This research was conducted at an academic hospital in Saudi Arabia. The study used cross-sectional research with a questionnaire. Participants were enrolled in the study through BC survivors' groups on WhatsApp. Individuals who were actively following up at the clinic were also interviewed. Informed consent was obtained. RESULTS The study surveyed 211 BC survivors, aged 34-49 (50.2%), who had undergone surgery (93.4%), hormonal therapy (66.4%), and chemotherapy (87.7%). Less than half (44.5%) had chronic conditions such as diabetes and hypertension. CAM users were 43.6%. The most used CAM modalities were Zamzam water, honey, and water read-upon Quran. A significant motivator for CAM use was to boost the immune system. More than half of patients used less than 100 SAR per month on CAM modalities. Exactly 80.4% of CAM users perceived benefits from CAM use. Predictors of CAM use included higher family monthly income, radiation therapy, and being diagnosed from 1 to 5 years. BC survivors without medical conditions after diagnosis were less likely to use CAM. CONCLUSION The study highlights the prevalence, predictive factors, motivations, and perceived benefits of CAM use among BC survivors in Saudi Arabia, emphasizing the need for understanding and integration into cancer care plans and the need for further research on CAM safety and efficacy.
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Affiliation(s)
- Atlal Abusanad
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Reem Ujaimi
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Marah A Alotaibi
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Lama A Alharbi
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Nouf Alatawi
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Abeer A Algarni
- Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
| | - Ali Samkari
- Surgery, Faculty of Medicine, King Abdulaziz University (KAUH), Jeddah, SAU
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Movafagh S, Adams E. The impact of a pharmacist-led cultural competence training on provider perceived preparedness and clinical care in patients with diabetes of Asian descent. J Am Pharm Assoc (2003) 2024; 64:62-70.e1. [PMID: 37797919 DOI: 10.1016/j.japh.2023.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 09/01/2023] [Accepted: 09/28/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND Patients of Asian descent are under-represented in the U.S. health care system and provider cultural competence is inadequate in addressing Asian health disparities. OBJECTIVES The purpose of this study was to evaluate the impact of the pharmacist-led cultural competence training on provider self-perceived preparedness and diabetes-related health outcomes in patients of Asian descent. METHODS This study is a cross-sectional followed by a quasi-experimental design conducted in 2 phases in a primary care clinic. Phase one evaluated the association of providers' cross-cultural care survey (CCCS) scores with patients' diabetic health indices: hemoglobin A1c (HbA1C), systolic blood pressure (SBP), diastolic blood pressure, and body mass index. Phase 2 examined the impact of pharmacist-led cultural competence training on providers' cross-cultural competency using survey analysis as well as pre- and post-training diabetic health indices in patients of Asian descent. RESULTS Phase 1 CCCS results showed baseline cross-cultural competence of the providers is inadequate (N = 9 providers). Furthermore, a significant negative correlation was found between providers' CCCS score and patients' HbA1C (N = 49, P = 0.04). Phase 2 showed that cultural competence training significantly reduced providers' self-perceived "un-preparedness" to care for patients of alternative cultures (N = 30 providers). Average diabetic health indices for all patients (N = 95) before and after the training were not significantly different. In the subset of patients with uncontrolled diabetes (HbA1C ≥ 7), SBP and HbA1C were significantly reduced after the training (P = 0.032 and P = 0.039, respectively). CONCLUSIONS Pharmacist-led cultural competence training had a positive impact on provider self-assessment and diabetic clinical outcomes in uncontrolled patients.
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Rao VS, Armour M, Cheema BS, Smith CA, Moran L, Perera RS, Lim S, Gupta S, De Manincor M, Vaidya R, Ee C. Use of traditional and complementary medicine by ethnic Indian women living with polycystic ovary syndrome: a global survey. BMC Complement Med Ther 2023; 23:392. [PMID: 37924068 PMCID: PMC10623873 DOI: 10.1186/s12906-023-04229-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/20/2023] [Indexed: 11/06/2023] Open
Abstract
BACKGROUND Traditional, complementary, and integrative medicine (TCIM) is commonly used by those living with Polycystic Ovary Syndrome (PCOS) but little is known about the use of TCIM such as yoga and Ayurveda in ethnic Indian women with PCOS living worldwide. This survey aimed to explore the prevalence and types of TCIM used and in particular the pattern of use of yoga and Ayurveda including reasons for not using and future interest in using them among non-users. METHOD An online, international cross-sectional survey was conducted using a pre-designed survey tool. Participants were ethnic Indian women of reproductive age who reported that they were medically diagnosed with PCOS. Descriptive analysis was used to identify the proportion of TCIM users, while a multivariable binary logistic regression was used to analyze their characteristics. RESULTS Data from 3130 respondents were analysed. The prevalence of TCIM use was 80% (2515/3130). Yoga and Ayurveda were the most frequently practised TCIM modalities with a prevalence of 57% and 37% respectively. We found a high future interest in using yoga (81%) and Ayurveda (70%) among the non-users. The motivation for most Ayurveda use was a recommendation from family/friends (66%), rather than personal choice (38%) or the internet (19%). Most women used Ayurveda because it has natural ingredients (64%) and it is safe (60%) and cited its use to be safe and somewhat helpful. The majority of women were currently practising yoga (73%) up to four times a week (54%) at home (93%). Yoga was primarily used to improve overall health (67%), manage weight (64%), stress (54%) hormonal imbalance (49%) and emotional well-being (48%). Barriers to practising yoga were common among the current users and non-users and included lack of motivation (59% and 59%), time constraints (48% and 39%), and non-availability of yoga teachers specialised in PCOS (31% and 23%). Most women found yoga to be helpful and preferred individual one-on-one (52%) yoga sessions specifically tailored for PCOS (58%). CONCLUSION This is the first international study that discovered the prevalence and pattern of TCIM use among ethnic Indian women with PCOS living worldwide. We support the urgent need for more research, education, and regulation of different TCIM modalities to promote safe and effective practices globally.
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Affiliation(s)
- Vibhuti Samarth Rao
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2571, Australia.
| | - Mike Armour
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2571, Australia
| | - Birinder S Cheema
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, 2560, Australia
| | - Caroline A Smith
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2571, Australia
| | - Lisa Moran
- Monash Centre for Health Research and Implementation, Monash University, Clayton, VIC, 3168, Australia
| | - Romain S Perera
- Department of Cell and Developmental Biology, University College London, London, WC1E 6BT, UK
| | - Siew Lim
- Health Systems and Equity, Eastern Health Clinical School, Monash University, Boxhill, VIC, 3128, Australia
| | - Sabrina Gupta
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, 3689, Australia
| | - Michael De Manincor
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2571, Australia
| | - Rama Vaidya
- Division of Endocrine and Metabolic Disorders, Kasturba Health Society's Medical Research Centre, Mumbai, 400056, India
| | - Carolyn Ee
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, 2571, Australia.
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Chen L, Hu Y, Ye Z, Li L, Qian H, Wu M, Qin K, Li N, Wen X, Pan T, Ye Q. Major Indole Alkaloids in Evodia Rutaecarpa: The Latest Insights and Review of Their Impact on Gastrointestinal Diseases. Biomed Pharmacother 2023; 167:115495. [PMID: 37741256 DOI: 10.1016/j.biopha.2023.115495] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 09/10/2023] [Accepted: 09/12/2023] [Indexed: 09/25/2023] Open
Abstract
Evodia rutaecarpa, the near-ripe fruit of Euodia rutaecarpa (Juss.) Benth, Euodia rutaecarpa (Juss.) Benth. var. officinalis (Dode) Huang, or Euodia rutaecarpa (Juss.) Benth. var. bodinieri (Dode) Huang, is a famous herbal medicine with several biological activities and therapeutic values, which has been applied for abdominalgia, abdominal distension, vomiting, and diarrhea as a complementary and alternative therapy in clinic. Indole alkaloids, particularly evodiamine (EVO), rutaecarpine (RUT), and dedhydroevodiamine (DHE), are received rising attention as the major bioactivity compounds in Evodia rutaecarpa. Therefore, this review summarizes the physicochemical properties, pharmacological activities, pharmacokinetics, and therapeutic effects on gastrointestinal diseases of these three indole alkaloids with original literature collected by PubMed, Web of Science Core Collection, and CNKI up to June 2023. Despite sharing the same parent nucleus, EVO, RUT, and DHE have different structural and chemical properties, which result in different advantages of biological effects. In their wide range of pharmacological activities, the anti-migratory activity of RUT is less effective than that of EVO, and the neuroprotection of DHE is significant. Additionally, although DHE has a higher bioavailability, EVO and RUT display better permeabilities within blood-brain barrier. These three indole alkaloids can alleviate gastrointestinal inflammatory in particular, and EVO also has outstanding anti-cancer effect, although clinical trials are still required to further support their therapeutic potential.
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Affiliation(s)
- Liulin Chen
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Yu Hu
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Zhen Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Linzhen Li
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Huanzhu Qian
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Mingquan Wu
- Department of Pharmacy, Sichuan Province Orthopedic Hospital, Chengdu 610041, China
| | - Kaihua Qin
- Health Preservation and Rehabilitation College, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Nan Li
- School of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China
| | - Xudong Wen
- Department of Gastroenterology, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu 610059, China
| | - Tao Pan
- Department of Gastroenterology, Chengdu Integrated TCM & Western Medicine Hospital, Chengdu 610059, China.
| | - Qiaobo Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 611137, China.
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Garrett B, Caulfield T, Musoke R, Murdoch B, Tang X, Lam JST. Demographic and psychometric predictors associated with engagement in risk-associated alternative healthcare behaviours. PLoS One 2023; 18:e0291016. [PMID: 37733748 PMCID: PMC10513319 DOI: 10.1371/journal.pone.0291016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/20/2023] [Indexed: 09/23/2023] Open
Abstract
This paper builds on prior work exploring the use of risk-associated alternative healthcare (RAAH) in Canada. RAAH uptake was surveyed to explore the characteristics of adult RAAH users and the value of established psychometric instruments previously used in alternative healthcare studies in predicting RAAH behaviours: the Control Beliefs Inventory (CBI), the Reward Responsiveness Behavioural Activation System (RBAS) scale, the Positive Attitudes to Science (PAS) scale, the Satisfaction with Orthodox Medicine (SOM) scale, and the brief version of the Susceptibility to Persuasion-II (StP-II-B) scale. Findings suggest RAAH is influenced by gender, age, income, education, employment, chronic illness status, and ethnicity. Engagement in some form of RAAH was common (around 40%) and the most common types of RAAH use reported were physical manipulation and herbal/nutritional supplement use. Other higher-risk AH activities (such as use of toxins and physically invasive procedures) were also reported by about 5% of respondents. The StP-II-B and PAS instruments were predictive of the likelihood of engagement in RAAH behaviours, as illustrated by higher risk tolerance, desire for novelty, positive attitude to advertising and social influence, and positive beliefs about science. The CBI, RBAS, and SOM instruments were not predictive overall. However, the CBI and SOM instruments were predictive of engagement with physical manipulative RAAH activities, while the RBAS was predictive of herbal/nutritional RAAH engagement. These findings can help inform health professionals' understanding of public health-seeking behaviours with respect to risk.
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Affiliation(s)
- Bernie Garrett
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Timothy Caulfield
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Musoke
- School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Blake Murdoch
- Health Law Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Xuyan Tang
- Department of Educational and Counselling Psychology, and Special Education, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joyce S. T. Lam
- Pacific Parkinson’s Research Centre, Djavad Mowafaghian Centre for Brain Health, University of British Columbia, Vancouver, British Columbia, Canada
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Miller EA, Beaumont S, Zhou ZN, Brewer JT, Thomas C, Chapman-Davis E, Cantillo E, Holcomb K, Pua T, Frey MK. Attitudes and beliefs regarding complementary and alternative medicine in a diverse gynecologic oncology patient population. Gynecol Oncol Rep 2023; 48:101232. [PMID: 37415958 PMCID: PMC10320404 DOI: 10.1016/j.gore.2023.101232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/20/2023] [Accepted: 06/22/2023] [Indexed: 07/08/2023] Open
Abstract
Objectives To measure prevalence of complementary and alternative medicine (CAM) use in a diverse gynecologic oncology patient population and evaluate how attitudes and beliefs regarding CAM relate to demographic factors. Methods A validated Attitudes and Beliefs about Complementary and Alternative Medicine (ABCAM) survey was distributed to patients with gynecologic malignancy. Results were evaluated using Pearson's Chi-squared and Fisher's exact tests for categorical variables and Wilcoxon ranks sum and Kruskal-Wallace tests for non-normally distributed variables. Results One-hundred thirty patients completed the ABCAM survey. Self-reported race and ethnicity included Asian or Pacific Islander (n = 54; 42%), Hispanic/Latino (n = 23; 18%), White (n = 21; 16%), Black or African American (n = 20; 15%), American Indian/Alaska Native (n = 8; 6.2%) and Other (n = 4; 3.1%). Twenty-four respondents (18%) reported use of CAM. There was a significant difference in expected benefits to CAM between respondents of different races/ethnicities (p < 0.001). Black and Asian respondents reported greater expected benefit to CAM. Hispanic/Latino, American Indian/Alaskan Native, and White respondents reported fewer expected benefits. A significant association was found between perceived barriers to CAM and race/ethnicity (p 0.043), with Asian, Hispanic/Latino and White respondents perceiving more barriers while Black and American Indian/Alaskan Natives reported perceiving fewer barriers to CAM. Respondents with incomes greater than $100,000 reported fewer barriers to CAM. Conclusions Use of CAM among gynecologic oncology patients is lower than previously thought. Income, race, and ethnicity inform patient engagement with CAM and can be used to better tailor the provision of evidence-based CAM interventions to benefit a greater number of gynecologic cancer patients.
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Affiliation(s)
- Emily A. Miller
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Shanice Beaumont
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Zhen Ni Zhou
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Michigan Medicine, 1500 E. Medical Center Dr., Ann Arbor, MI 48109, USA
| | - Jesse T. Brewer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Charlene Thomas
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Eloise Chapman-Davis
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Evelyn Cantillo
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Kevin Holcomb
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Tara Pua
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
| | - Melissa K. Frey
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, New York Presbyterian Hospital Weill Cornell Medicine, 525 E 68th St, New York, NY 10065, USA
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Gao Y, Heller SL. Health Disparity and Breast Cancer Outcomes in Asian Women. Radiographics 2022; 42:1912-1924. [PMID: 36053846 DOI: 10.1148/rg.220074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Health disparities in Asian women are complex and multifactorial. Screening attendance is low among Asian women, regardless of nativity or acculturation, and breast cancer detection has decreased by more than half in this population during the COVID-19 pandemic. The follow-up rate after abnormal screening results is similarly poor among Asian women compared with that among other groups, often resulting in a delay of cancer diagnosis. Yet the incidence of breast cancer in Asian women is increasing in the United States, with no such increase observed in other racial and ethnic groups in recent years. The age distribution of breast cancer in Asian women is distinct and peaks in younger women, underscoring the importance of early screening. The predilection for human epidermal growth factor receptor 2 (HER2)-enriched tumors may reflect the unique biologic characteristics of breast cancer among Asian subgroups, which are not well understood. Known biomarkers for breast cancer risk such as body mass index and mammographic density do not perform the same way in Asian women, as compared with other groups, owing to a lack of Asian population-specific data. Within that limitation, the association between body mass index and breast cancer is strongest in older Asian women, and the association between breast density and breast cancer is strongest in younger Asian women. There is an unmet need to improve breast cancer care in Asian women, a heterogeneous and growing population that is facing an increasing burden of breast cancer. An invited commentary by Leung is available online. ©RSNA, 2022.
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Affiliation(s)
- Yiming Gao
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
| | - Samantha L Heller
- From the Department of Radiology, New York University School of Medicine, 160 E 34th St, New York, NY 10016
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Jamil A, Jonkman LJ, Miller M, Jennings L, Connor SE. Medication adherence and health beliefs among South Asian immigrants with diabetes in the United States: A qualitative study. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2022. [DOI: 10.1002/jac5.1668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Amna Jamil
- UPMC Presbyterian‐Shadyside Pittsburgh Pennsylvania USA
| | - Lauren J. Jonkman
- Department of Pharmacy & Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
| | - Michelle Miller
- University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
| | - Luke Jennings
- University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
| | - Sharon E. Connor
- Department of Pharmacy & Therapeutics University of Pittsburgh School of Pharmacy Pittsburgh Pennsylvania USA
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El-Khouly FE, Adil SM, Wiese M, Hulleman E, Hendrikse NH, Kaspers GJL, Kramm CM, Veldhuijzen van Zanten SEM, van Vuurden DG. Complementary and alternative medicine in children with diffuse intrinsic pontine glioma-A SIOPE DIPG Network and Registry study. Pediatr Blood Cancer 2021; 68:e29061. [PMID: 33942498 DOI: 10.1002/pbc.29061] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 03/27/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive childhood brainstem malignancy with a 2-year survival rate of <10%. This international survey study aims to evaluate the use of complementary and alternative medicine (CAM) in this patient population. METHODS Parents and physicians of patients with DIPG were asked to participate in a retrospective online survey regarding CAM use during time of illness. RESULTS Between January and May 2020, 120 parents and 75 physicians contributed to the online survey. Most physicians estimated that <50% of their patients used CAM, whereas 69% of the parents reported using CAM to treat their child during time of illness. Cannabis was the most frequently used form of CAM, followed by vitamins and minerals, melatonin, curcumin, and boswellic acid. CAM was mainly used with the intention of direct antitumor effect. Other motivations were to treat side effects of chemotherapy or to increase comfort of the child. Children diagnosed from 2016 onwards were more likely to use CAM (χ2 = 6.08, p = .014). No significant difference was found between CAM users and nonusers based on ethnicity (χ2 = 4.18, p = .382) or country of residence (χ2 = 9.37, p = .154). Almost 50% of the physicians do not frequently ask their patients about possible CAM use. CONCLUSION This survey demonstrates that worldwide, a considerable number of patients with DIPG use CAM. Physicians should be more aware of potential CAM use and actively discuss the topic. In addition, more research is needed to gain knowledge about possible anticancer effects of CAM and (positive/negative) interactions with conventional therapies.
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Affiliation(s)
- Fatma E El-Khouly
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Syed M Adil
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maria Wiese
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Medical Center Goettingen, Goettingen, Germany
| | - Esther Hulleman
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - N Harry Hendrikse
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Clinical Pharmacology and Pharmacy, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gertjan J L Kaspers
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Christof M Kramm
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, University Medical Center Goettingen, Goettingen, Germany
| | - Sophie E M Veldhuijzen van Zanten
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Radiology & Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Dannis G van Vuurden
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Sohn YJ, Chang CY, Miles RC. Current Gaps in Breast Cancer Screening Among Asian and Asian American Women in the United States. J Am Coll Radiol 2021; 18:1376-1383. [PMID: 34174207 DOI: 10.1016/j.jacr.2021.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/07/2021] [Accepted: 06/07/2021] [Indexed: 11/15/2022]
Abstract
Over the past two decades, the US Asian population has increased 72%, representing the fastest growth rate of any major racial group. Currently, there are over 20 million Asian and Asian American women in the United States, who identify with at least 1 of 19 different origin groups. Although women of Asian ancestry have traditionally been considered low risk for experiencing adverse breast cancer-specific outcomes, aggregated data may mask health disparities seen among subgroups. In the United States, recent data demonstrate that the burden of breast cancer among Asian women has increased each year over the past decade. We aim to characterize challenges faced by Asian and Asian American women in the United States related to cultural stigma, socioeconomic status, and overall access to breast cancer care. An increased understanding of barriers to breast cancer prevention and treatment efforts is needed to develop more effective strategies aimed at reducing disparities in care among segments of this heterogenous population.
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Affiliation(s)
| | - Connie Y Chang
- Associate Professor of Radiology, Department of Radiology, Boston, Massachusetts; Radiology Wellbeing Officer, Department of Radiology, Boston, Massachusetts
| | - Randy C Miles
- Clinical Service Chief, Division of Breast Imaging, Department of Radiology, Boston, Massachusetts.
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Tsoy E, Kiekhofer RE, Guterman EL, Tee BL, Windon CC, Dorsman KA, Lanata SC, Rabinovici GD, Miller BL, Kind AJH, Possin KL. Assessment of Racial/Ethnic Disparities in Timeliness and Comprehensiveness of Dementia Diagnosis in California. JAMA Neurol 2021; 78:657-665. [PMID: 33779684 PMCID: PMC8008426 DOI: 10.1001/jamaneurol.2021.0399] [Citation(s) in RCA: 69] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 12/29/2020] [Indexed: 12/12/2022]
Abstract
Importance The US aging population is rapidly becoming more racially and ethnically diverse. Early diagnosis of dementia is a health care priority. Objective To examine the associations between race/ethnicity and timeliness of dementia diagnosis and comprehensiveness of diagnostic evaluation. Design, Setting, and Participants This retrospective cross-sectional study used 2013-2015 California Medicare fee-for-service data to examine the associations of race/ethnicity, individual factors, and contextual factors with the timeliness and comprehensiveness of dementia diagnosis. Data from 10 472 unique beneficiaries were analyzed. The sample was selected on the basis of the following criteria: presence of 1 or more claims; no diagnoses of dementia or mild cognitive impairment in 2013 to 2014; continuous enrollment in Medicare Parts A and B; Asian, Black, Hispanic, or White race/ethnicity; and incident diagnoses of dementia or mild cognitive impairment in January through June 2015. Data analyses were conducted from November 1, 2019, through November 10, 2020. Main Outcomes and Measures Timeliness of diagnosis, defined as incident diagnosis of mild cognitive impairment vs dementia, and comprehensiveness of diagnostic evaluation, defined as presence of the following services in claims within 6 months before or after the incident diagnosis date: specialist evaluation, laboratory testing, and neuroimaging studies. Results The sample comprised 10 472 unique Medicare beneficiaries with incident diagnoses of dementia or mild cognitive impairment (6504 women [62.1%]; mean [SD] age, 82.9 [8.0] years) and included 993 individuals who identified as Asian (9.5%), 407 as Black (3.9%), 1255 as Hispanic (12.0%), and 7817 as White (74.6%). Compared with White beneficiaries, those who identified as Asian (odds ratio, 0.46; 95% CI, 0.38-0.56), Black (odds ratio, 0.73; 95% CI, 0.56-0.94), or Hispanic (odds ratio, 0.62; 95% CI, 0.52-0.72) were less likely to receive a timely diagnosis. Asian beneficiaries (incidence rate ratio, 0.81; 95% CI, 0.74-0.87) also received fewer diagnostic evaluation elements. These associations remained significant after adjusting for age, sex, comorbidity burden, neighborhood disadvantage, and rurality. Conclusions and Relevance These findings highlight substantial disparities in the timeliness and comprehensiveness of dementia diagnosis. Public health interventions are needed to achieve equitable care for people living with dementia across all racial/ethnic groups.
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Affiliation(s)
- Elena Tsoy
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Rachel E. Kiekhofer
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Elan L. Guterman
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Boon Lead Tee
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Charles C. Windon
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
| | - Karen A. Dorsman
- Department of Psychiatry, The University of Texas Southwestern Medical Center, Dallas
| | - Serggio C. Lanata
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
- Global Brain Health Institute, University of California, San Francisco, San Francisco
| | - Gil D. Rabinovici
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
- Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco
- Associate Editor, JAMA Neurology
| | - Bruce L. Miller
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
- Global Brain Health Institute, University of California, San Francisco, San Francisco
| | - Amy J. H. Kind
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison
- Geriatrics Research Education and Clinical Center, Madison Veterans Affairs Hospital, Madison, Wisconsin
| | - Katherine L. Possin
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, San Francisco
- Global Brain Health Institute, University of California, San Francisco, San Francisco
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Wong YK, Tan KL, Haneline MT. Chiropractic Utilization Among Patients in Klang Valley, Malaysia. J Chiropr Med 2020; 19:159-166. [PMID: 33362438 PMCID: PMC7750825 DOI: 10.1016/j.jcm.2019.10.003] [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] [Received: 05/09/2019] [Revised: 07/22/2019] [Accepted: 10/10/2019] [Indexed: 10/25/2022] Open
Abstract
OBJECTIVE The purpose of this study was to estimate the utilization of chiropractic in Klang Valley, Malaysia. METHODS This research was a cross-sectional study conducted in 4 health care centers, namely Klinik Mediviron Sri Rampai, Queck Dental Surgery, International Medical University (IMU) Healthcare Chiropractic Centre, and Be Pharmacy Bandar Sri Permaisuri, in Klang Valley from July to November 2018, with a total of 440 respondents. The data collection was done by the self-administration method using questionnaires that were enclosed in envelopes and passed on to the participants by the center's staff. Descriptive statistics were conducted on the data collected and are presented in tables and figures. The variables were sex, age, nationality, ethnicity, marital status, education level, employment status, and health status with the utilization of chiropractic. RESULT There were 186 (42.3%) male and 254 (57.7%) female respondents. The youngest respondent was 18 years old, and the oldest was 81 years old. The median age was 30 years old. Most respondents (97.3%) were Malaysian from a non-Bumiputra (non-Malay) ethnic group. Almost half (47.5%) of the respondents had a bachelor's degree education level. The utilization of chiropractic was 35.9% (95% confidence interval [CI]: 31.4-40.5). CONCLUSION The utilization of chiropractic was 35.9%, which was slightly lower than utilization among other traditional and complementary medicine practices in Malaysia.
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Affiliation(s)
- Yi Kai Wong
- Department of Chiropractic, Centre for Complementary and Alternative Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Kok Leong Tan
- Department of Community Medicine, School of Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
| | - Michael Thomas Haneline
- Department of Chiropractic, Centre for Complementary and Alternative Medicine, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia
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Abstract
OBJECTIVE South Asians (SAs), a rapidly growing minority group in the United States are underrepresented in mental health research. They represent a unique sub-group of Asian immigrants in that their journey to the United States in the last 50 years was driven by the pursuit of academic and career opportunities. Our goal is to provide a topical overview of factors contributing to the mental health challenges of South Asian American (SAA) youth and to describe culturally sensitive approaches that would provide effective treatment for SAA youth and their families. METHODS We conducted a review of published literature in PubMed and PsycInfo search engines using the key words South Asian immigrants, South Asian Americans, psychological, psychiatric, mental health treatment, therapy and interventions. RESULTS The challenges faced by these highly educated families are distinctive in that there is a struggle to maintain ethnic identity based on collectivism while embracing American ideals of individualism. These opposing values along with model minority expectations put SAs at high risk for mental health concerns and acculturative family distancing. Furthermore, mental health stigma impedes help-seeking. Mental health practitioners must navigate the different value systems of the parent-child dyad without ostracizing either generation and deliver effective care. Hence, culturally adapted family therapy and community-based approaches may be particularly relevant in SA youth. CONCLUSION Our article outlines common family attitudes and issues pertinent to mental health in youth and discusses useful clinical approaches to dealing with SAA youth and their families.
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Affiliation(s)
- Neha Sharma
- Division of Child and Adolescent Psychiatry, Tufts Medical Center, Boston, MA, USA
| | - Deepika Shaligram
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA
| | - Grace H Yoon
- Department of Health Law, Policy & Management, Boston University School of Public Health, Boston, MA, USA
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Felicilda-Reynaldo RFD, Choi SY, Driscoll SD, Albright CL. A National Survey of Complementary and Alternative Medicine Use for Treatment Among Asian-Americans. J Immigr Minor Health 2020; 22:762-770. [PMID: 31583560 PMCID: PMC7117985 DOI: 10.1007/s10903-019-00936-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Asian Americans (AAs) are more likely to use complementary and alternative medicine (CAM) compared to other race/ethnicities, yet previous studies have conflicting results. The 2012 National Health Interview Survey data was analyzed to investigate AA's (n = 2214) CAM use for treatment. AAs were divided into four subgroups: Chinese, Asian Indian, Filipino, and Other Asian. Only 9% of AAs reported using CAM for treatment, with 6% indicating CAM use specifically for chronic conditions. This could be a form of medical pluralism, a mixture of Eastern and Western health approaches. The "Other Asian" subgroup reported highest use of CAM for treatment. Significant predictors included age (≥ 65 years) and high educational attainment (≥ college degree). Sociodemographic factors were also significant predictors within Asian subgroups. Further investigation of this and other forms of medical pluralism among AAs are needed to explore potential cofounders and risks like underreporting, CAM schedules/dosages, cultural influences, and CAM's impact on one's health.
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Affiliation(s)
- Rhea Faye D Felicilda-Reynaldo
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA.
| | - So Yung Choi
- Biostatistics Core, Department of Complementary and Integrative Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Susan D Driscoll
- School of Nursing and Dental Hygiene, University of Hawaii at Manoa, 2528 McCarthy Mall, Webster 402, Honolulu, HI, 96822, USA
| | - Cheryl L Albright
- Office of Public Health Studies, Myron B. Thompson School of Social Work, School of Nursing and Dental Hygiene, University of Hawaii at Manoa, Honolulu, HI, USA
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Gok Metin Z, Karadas C, Ozdemir L. Usage and attitudes related to complementary and alternative medicine among Turkish academicians on the basis of the five-factor model of personality: A multi-centered study. Complement Ther Med 2019; 44:151-156. [DOI: 10.1016/j.ctim.2019.04.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/08/2019] [Accepted: 04/18/2019] [Indexed: 12/20/2022] Open
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Sun K, Szymonifka J, Tian H, Chang Y, Leng JC, Mandl LA. Is Traditional Chinese Medicine Use Associated with Worse Patient-reported Outcomes among Chinese American Rheumatology Patients? J Rheumatol 2019; 46:1634-1639. [PMID: 31043540 DOI: 10.3899/jrheum.181148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/10/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Chinese Americans are a fast-growing immigrant group with more severe rheumatic disease manifestations than whites and often a strong cultural preference for traditional Chinese medicine (TCM). We aimed to examine TCM use patterns and association with patient-reported outcomes (PRO) among Chinese American rheumatology patients. METHODS Chinese Americans actively treated for systemic rheumatic diseases were recruited from urban Chinatown rheumatology clinics. Data on sociodemographics, acculturation, clinical factors, and TCM use (11 modalities) were gathered. Self-reported health status was assessed using Patient Reported Outcomes Measurement Information System (PROMIS) short forms. TCM users and nonusers were compared. Factors independently associated with TCM use were identified using multivariable logistic regression. RESULTS Among 230 participants, median age was 57 years (range 20-97), 65% were women, 71% had ≤ high school education, 70% were on Medicaid insurance, 47% lived in the United States for ≥ 20 years, and 22% spoke English fluently. Half used TCM in the past year; these participants had worse self-reported anxiety, depression, fatigue, and ability to participate in social roles and activities compared with nonusers. In multivariable analysis, TCM use was associated with belief in TCM, female sex, ≥ 20 years of US residency, reporting Western medicine as ineffective, and shorter rheumatic disease duration. CONCLUSION Among these Chinese American rheumatology patients, TCM users had worse PRO in many physical and mental health domains. TCM use may be a proxy for unmet therapeutic needs. Asking about TCM use could help providers identify patients with suboptimal health-related quality of life who may benefit from targeted interventions.
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Affiliation(s)
- Kai Sun
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA. .,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine.
| | - Jackie Szymonifka
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA.,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine
| | - Henghe Tian
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA.,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine
| | - Yaju Chang
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA.,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine
| | - Jennifer C Leng
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA.,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine
| | - Lisa A Mandl
- From the Division of Rheumatology, Department of Medicine, Duke University School of Medicine, Durham, North Carolina; New York University Sackler Institute of Graduate Biomedical Sciences; Division of Rheumatology, Department of Medicine, New York University School of Medicine; Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; Division of Rheumatology, Department of Medicine, Hospital for Special Surgery; Department of Medicine, Weill Cornell Medicine, New York, New York, USA.,K. Sun, MD, MS, Medical Instructor, Division of Rheumatology, Department of Medicine, Duke University School of Medicine; J. Szymonifka, MS, Graduate Research Assistant, New York University Sackler Institute of Graduate Biomedical Sciences; H. Tian, MD, Clinical Instructor, Division of Rheumatology, Department of Medicine, New York University School of Medicine; Y. Chang, MD, Assistant Professor, Division of Rheumatology, Department of Medicine, Mount Sinai Beth Israel; J.C. Leng, MD, MPH, Assistant Attending, Immigrant Health and Cancer Disparities Center, Memorial Sloan Kettering Cancer Center; L.A. Mandl, MD, MPH, Assistant Professor, Division of Rheumatology, Department of Medicine, Hospital for Special Surgery, and Department of Medicine, Weill Cornell Medicine
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Hsu O, Tsourounis C, Chan LLS, Dennehy C. Chinese Herb Use by Patients at a San Francisco Chinatown Public Health Center. J Altern Complement Med 2016; 22:751-6. [PMID: 27355102 DOI: 10.1089/acm.2015.0288] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVES Chinese herbal medicine (CHM) use has not been well characterized in persons living in the United States who receive care by Western-trained healthcare providers. The primary objective of this study was to characterize use of CHM taken in the last 12 months by patients seen at a Chinatown public health center. DESIGN Convenience sample survey. SETTING Data collection occurred over 3 months at a San Francisco Chinatown public health center. PARTICIPANTS Adult patients visiting their primary care provider. INTERVENTIONS Completion of a voluntary 24-question survey on CHM use. OUTCOME MEASURES Prevalence, type, and indications for use. RESULTS Survey response rate was 29% (50/170). Seventy percent (35/50) of respondents had used CHM in the last 12 months and 94% (33/35) were also taking prescription medicines. The three most commonly used CHM were goji berry (37%), Dioscorea (31%), and ginseng (23%). The most common indications for herbs used in the last 12 months were general wellness (34%), cold/flu (25%), and headache (6%). Sixty-four percent of respondents had used Western medicine in combination with CHM within the last 12 months. Sixty-nine percent of respondents who used CHM did not tell their Western provider about this use. No patient had CHM use documented in the electronic medical record. CONCLUSIONS Patients seen at a Chinatown public health center frequently used CHM products in conjunction with Western prescription medicines. Providers should routinely enquire about CHM use for health as a soup, tea, food, or pill and document this use in the medical record.
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Affiliation(s)
- Oliver Hsu
- 1 Santa Clara Valley Medical Center , San Jose, CA
| | - Candy Tsourounis
- 2 Medication Outcomes Center, University of California , San Francisco, School of Pharmacy, San Francisco, CA
| | | | - Cathi Dennehy
- 4 Department of Clinical Pharmacy, University of California , San Francisco, School of Pharmacy, San Francisco, CA
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Lor KB, Moua S, Ip EJ. Frequency and Perceptions of Herbal Medicine use Among Hmong Americans: a Cross Sectional Survey. J Immigr Minor Health 2015; 18:397-401. [DOI: 10.1007/s10903-015-0190-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Who practices yoga? A systematic review of demographic, health-related, and psychosocial factors associated with yoga practice. J Behav Med 2015; 38:460-71. [PMID: 25627668 DOI: 10.1007/s10865-015-9618-5] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2013] [Accepted: 01/11/2015] [Indexed: 12/17/2022]
Abstract
Yoga has become increasingly popular in the US and around the world, yet because most yoga research is conducted as clinical trials or experiments, little is known about the characteristics and correlates of people who independently choose to practice yoga. We conducted a systematic review of this issue, identifying 55 studies and categorizing correlates of yoga practice into sociodemographics, psychosocial characteristics, and mental and physical well-being. Yoga use is greatest among women and those with higher socioeconomic status and appears favorably related to psychosocial factors such as coping and mindfulness. Yoga practice often relates to better subjective health and health behaviors but also with more distress and physical impairment. However, evidence is sparse and methodological limitations preclude drawing causal inferences. Nationally representative studies have minimally assessed yoga while studies with strong assessment of yoga practice (e.g., type, dose) are generally conducted with convenience samples. Almost all studies reviewed are cross-sectional and few control for potential confounding variables. We provide recommendations for future research to better understand the correlates of yoga practice.
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Ghiasuddin A, Wong J, Siu AM. Ethnicity, traditional healing practices, and attitudes towards complementary medicine of a pediatric oncology population receiving healing touch in Hawaii. Asia Pac J Oncol Nurs 2015; 2:227-231. [PMID: 27981117 PMCID: PMC5123507 DOI: 10.4103/2347-5625.158015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Objective: Cultural competence among healthcare providers is becoming increasingly important. Hawai’i is an ethnically diverse island state that has a high rate of traditional and complementary medicine use. We previously reported on the feasibility of delivering Healing Touch (HT) to pediatric oncology patients, and its impact on pain, distress and fatigue. Our current objective is to examine the ethnic and cultural characteristics of this patient population, including traditional health related beliefs. Methods: Demographic data and feedback from subjects and their families from the 2009-2010 HT study conducted in Honolulu were analyzed. Results: The majority of the participants were Asian American and/or Native Hawaiian or other Pacific Islander. Almost half of the participants were more than one race. Traditional cultural health related beliefs, as reported by patients and families, sometimes aligned with patient's experiences with HT, however, degree of acculturation/time living in the United States seemed to play a role as well, with younger generation perhaps being less “traditional”. Common health related themes/values across the predominant cultures were 1) emphasis on family/clan and 2) mind/body connection. Conclusions: HT appeared to be well accepted by subjects from a variety of ethnic backgrounds. Several patients had attitudes/beliefs around healthcare that were rooted in their traditional cultural values, but this was not universal. Knowledge of different cultural attitudes on health, and traditional/complementary medicine, will improve patient care. Future areas of research could examine the acceptance of HT among pediatric oncology patients in geographic areas with differing cultural demographics (i.e., continentalUnited States or internationally).
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Affiliation(s)
- Asad Ghiasuddin
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA
| | - Joyce Wong
- Department of Child Life, Kapiolani Medical Center for Women and Children, Honolulu, HI, USA
| | - Andrea M Siu
- Research Institute, Hawaii Pacific Health, Honolulu, HI, USA
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Liu MA, Huynh NT, Broukhim M, Cheung DH, Schuster TL, Najm W. Determining the attitudes and use of complementary, alternative, and integrative medicine among undergraduates. J Altern Complement Med 2014; 20:718-26. [PMID: 24992360 DOI: 10.1089/acm.2014.0041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To (1) determine the attitudes, perceptions, and use of complementary, alternative, and integrative medicine among undergraduate students; (2) assess whether these students would benefit from more academic exposure to complementary and alternative medicine (CAM) and promotion of integrative medicine (IM); and (3) gauge the need and desire of undergraduates, particularly pre-health learners, to take courses about CAM/IM. METHODS This cross-sectional electronic survey study was conducted on the campus of the University of California (UC) Irvine. Selection criteria included being at least 18 years of age and a current undergraduate at UC Irvine. All survey responses were collected between November 20, 2010, and June 1, 2011. The data were analyzed by using Stata software, version 11-SE (Stata Corp., College Station, TX). RESULTS Completed surveys were received from 2839 participants (mean age of respondents, 20.2 years). Thirty-five percent had used CAM within the past 12 months, and 92.8% believed CAM to be at least somewhat effective; however, only 31% had prior education on CAM. After adjustment for variables, familiarity and belief in effectiveness were both highly linked to the use of CAM, with ascending odds ratios (ORs; 95% confidence interval [CI]) of 3.9 (3.1-4.9), 8.1 (5.7-11.5), 13.4 (6.0-30.2), 2.1 (1.3-3.4), 4.9 (3.0-7.8), and 12.7 (6.9-23.4) among increasing categories (all p<0.01). Sex (OR, 1.26 [95% CI, 1.01-1.56]; p<0.05), Asian ethnicity (1.46 [1.14-1.88]; p<0.01), and prior education (1.26 [1.01-1.57]; p<0.05) were also significantly correlated to the use of CAM after adjustment. Most respondents indicated that they were likely to take a CAM college course if it fulfilled a graduation requirement (63.6%) or was offered within their major (56.4%). CONCLUSIONS Overall, this large-scale study supports the ideas that education plays a pivotal factor in the decision to use CAM and that there is a large demand for additional CAM knowledge among college students.
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Affiliation(s)
- Michael A Liu
- 1 Susan Samueli Center for Integrative Medicine, affiliated with School of Medicine, University of California , Irvine, Costa Mesa, CA
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Lin HW, Tsai HH, Yu IW, Kumar A, Wu MP. Would It Matter to Expose Elderly Patients Who Took Digoxin to Chinese Medications? Value Health Reg Issues 2014; 3:211-221. [PMID: 29702930 DOI: 10.1016/j.vhri.2014.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Elderly patients seem vulnerable to digoxin toxicity because of their diminished organ functions and tendency to encounter drug interactions. The aim of this research was to explore the extent of the concurrent use of digoxin with Chinese medications (CMs), its contributing factors, and the relevant consequences. METHODS A retrospective population-based cohort study was conducted using Longitudinal Health Insurance databases in Taiwan. Those elderly patients being prescribed with digoxin in outpatient settings in 2006 were evaluated for the incidence, prevalence, and duration of concurrent use with concentrated CMs in 2006. After 1:1 random matching to select the corresponding digoxin-only elderly users, univariate and multivariate logistic regression analyses were performed to explore factors associated with concomitant incident digoxin-CM use and incident digoxin-specific CM use. The relevant clinical and economic outcomes for a 3-month follow-up period from the initial exposure of incident digoxin-CM use were compared. RESULTS Of 185,076 elderly, 6,374 were prescribed with digoxin and 789 were CM-digoxin users in 2006. The prevalence and incidence of concomitant CM use among digoxin elderly users were 0.43% and 0.22%, respectively. Although the other factors were not statistically significantly associated with incident CM-digoxin use, patients with heart diseases and with benign prostate hypertrophy had an increased likelihood of incident CM-digoxin use of 115% and 102%, respectively. Almost all the concerned clinical and economic outcomes were not statistically significantly different between incident exposure or not, except for the use of potassium-sparing and nonsteroidal anti-inflammatory drugs. CONCLUSIONS There was a relatively low incidence of digoxin-CM use among the elderly in Taiwan. Although no significant effects on clinical and economic outcomes occurred, it is necessary to monitor potential side effects of digoxin more aggressively for those vulnerable elderly using digoxin with CMs, especially for those who tended to expose to incident digoxin-CM use elderly patients.
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Affiliation(s)
- Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan, ROC; Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan, ROC.
| | - Hsin-Hui Tsai
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan, ROC; Department of Cosmetic Science, Providence University, Taichung, Taiwan, ROC
| | - I-Wen Yu
- Department of Pharmacy, China Medical University Hospital, Taichung, Taiwan, ROC
| | - Arun Kumar
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan, ROC
| | - Man-Pin Wu
- School of Pharmacy and Graduate Institute, College of Pharmacy, China Medical University, Taichung, Taiwan, ROC
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Locke AB, Gordon A, Guerrera MP, Gardiner P, Lebensohn P. Recommended integrative medicine competencies for family medicine residents. Explore (NY) 2014; 9:308-13. [PMID: 24021472 DOI: 10.1016/j.explore.2013.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND The use of complementary and alternative medicine (CAM) and Integrative Medicine (IM) has grown steadily over the past decade. Patients seek physician guidance, yet physicians typically have limited knowledge and training. There is some coverage of IM/CAM topics in medical schools and residencies but with little coordination or consistency. METHODOLOGY In 2008, the Society of Teachers of Family Medicine (STFM) group on Integrative Medicine began the process of designing a set of competencies to educate Family Medicine residents in core concepts of IM. The goal was creation of a set of nationally recognized competencies tied to the Accreditation Council for Graduate Medical Education (ACGME) domains. These competencies were to be achievable by diverse programs, including those without significant internal resources. The group compiled existing curricula from programs around the country and distilled these competencies through multiple reviews and discussions. Simultaneously, the Integrative Medicine in Residency program run by the University of Arizona underwent a similar process. In 2009, these competencies were combined and further developed at the STFM annual meeting by a group of experts. RESULTS In 2010, the STFM Board approved 19 measurable competencies, each categorized by ACGME domain, as recommended for Family Medicine residencies. Programs have implemented these competencies in various ways given individual needs and resources. CONCLUSIONS This paper reviews the development of IM competencies for residency education in Family Medicine and presents those endorsed by STFM. By educating physicians in training about IM/CAM via competency-based curricula, we aim to promote comprehensive patient-centered care.
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Affiliation(s)
- Amy B Locke
- Department of Family Medicine, University of Michigan Medical School, Ann Arbor, MI.
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Upchurch DM, Rainisch BW. A sociobehavioral wellness model of acupuncture use in the United States, 2007. J Altern Complement Med 2014; 20:32-9. [PMID: 23414108 PMCID: PMC3904513 DOI: 10.1089/acm.2012.0120] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES The purpose of this study was to provide updated and more comprehensive data on the correlates and patterns of acupuncture use in the United States, applying a sociobehavioral wellness model of utilization. Predisposing factors, enabling resources, need, and personal health practices were investigated. Patterns of recent usage, including assessing the reason for use based on treatment of a health condition, for wellness, or both, were examined. Also, for the first time, attitudes about acupuncture reported by previous users and never users were presented. DESIGN Data from the 2007 National Health Interview Survey (NHIS), a cross-sectional, household survey representative of the U.S. civilian population, were used, which included the Complementary and Alternative Medicine supplement. Adults 18 and over (n=22,512) were analyzed. Bivariate prevalence estimates were obtained and logistic regression models were estimated. In addition, all analyses were weighted. OUTCOME MEASURES The primary outcome measure was recent use of acupuncture, defined as any use in the past 12 months. RESULTS In 2007, 6.8% of adults reported lifetime use of acupuncture and 1.5% reported use in the past 12 months. Multivariate results showed significant effects in the expected directions for multiple variables in each of the four domains of our conceptual model (predisposing factors, enabling resources, need, and personal health practices). Among recent users, close to half reported some mention of wellness as a reason for use. Musculoskeletal conditions and pain were the top health conditions treated and these users, to some extent, integrated conventional and acupuncture care. Negative attitudes or skepticism about acupuncture were not common reasons for nonuse among prior and never users. CONCLUSIONS Application of a sociobehavioral wellness model to frame correlates and patterns of recent acupuncture use in the Unites States shows promise.
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Affiliation(s)
- Dawn M Upchurch
- Department of Community Health Sciences, UCLA School of Public Health , Los Angeles, CA
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Chien PS, Tseng YF, Hsu YC, Lai YK, Weng SF. Frequency and pattern of Chinese herbal medicine prescriptions for urticaria in Taiwan during 2009: analysis of the national health insurance database. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2013; 13:209. [PMID: 23947955 PMCID: PMC3751558 DOI: 10.1186/1472-6882-13-209] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 08/13/2013] [Indexed: 11/17/2022]
Abstract
Background Large-scale pharmaco-epidemiological studies of Chinese herbal medicine (CHM) for treatment of urticaria are few, even though clinical trials showed some CHM are effective. The purpose of this study was to explore the frequencies and patterns of CHM prescriptions for urticaria by analysing the population-based CHM database in Taiwan. Methods This study was linked to and processed through the complete traditional CHM database of the National Health Insurance Research Database in Taiwan during 2009. We calculated the frequencies and patterns of CHM prescriptions used for treatment of urticaria, of which the diagnosis was defined as the single ICD-9 Code of 708. Frequent itemset mining, as applied to data mining, was used to analyse co-prescription of CHM for patients with urticaria. Results There were 37,386 subjects who visited traditional Chinese Medicine clinics for urticaria in Taiwan during 2009 and received a total of 95,765 CHM prescriptions. Subjects between 18 and 35 years of age comprised the largest number of those treated (32.76%). In addition, women used CHM for urticaria more frequently than men (female:male = 1.94:1). There was an average of 5.54 items prescribed in the form of either individual Chinese herbs or a formula in a single CHM prescription for urticaria. Bai-Xian-Pi (Dictamnus dasycarpus Turcz) was the most commonly prescribed single Chinese herb while Xiao-Feng San was the most commonly prescribed Chinese herbal formula. The most commonly prescribed CHM drug combination was Xiao-Feng San plus Bai-Xian-Pi while the most commonly prescribed triple drug combination was Xiao-Feng San, Bai-Xian-Pi, and Di-Fu Zi (Kochia scoparia). Conclusions In view of the popularity of CHM such as Xiao-Feng San prescribed for the wind-heat pattern of urticaria in this study, a large-scale, randomized clinical trial is warranted to research their efficacy and safety.
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Liao YH, Lin JG, Lin CC, Li TC. Distributions of usage and the costs of conventional medicine and traditional chinese medicine for lung cancer patients in taiwan. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2013; 2013:984876. [PMID: 23956784 PMCID: PMC3730366 DOI: 10.1155/2013/984876] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 06/14/2013] [Accepted: 06/15/2013] [Indexed: 11/24/2022]
Abstract
Background. This study aims to analyze the utilization patterns of patients with lung cancer stratified by surgery status. Methods. A retrospective cohort study was conducted from 1996 to 2010 by using the Longitudinal Health Insurance Database 2005. Results. Among the 7,677 lung cancer patients, 230 (31.17%) and 1,826 (26.32%) who have and have not undergone surgery have used TCM outpatient services, respectively. For lung cancer patients who have not undergone surgery, patients who are aged 70 years and older, males, occupational members, and farmers and fishermen are less likely to avail of TCM services. For lung cancer patients who have undergone surgery, the likelihood of TCM users is higher in residents who used TCM one year prior to lung cancer diagnosis and in patients with insurance amounts ranging from ≥NT$60,000. The total amount paid per visit for WM is higher than that for one year of TCM outpatient care before and after lung cancer diagnosis. Conclusion. The factors associated with TCM use varied according to surgery status. The costs of insurance covering TCM were consistently lower than those covering WM for lung cancer patients. These findings would be useful for health policy makers who are considering TCM and WM integration.
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Affiliation(s)
- Yueh-Hsiang Liao
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Jaung-Geng Lin
- School of Chinese Medicine, China Medical University, Taichung 40402, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung 40402, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 40402, Taiwan
- Department of Medical Research, China Medical University Hospital, Taichung 40402, Taiwan
| | - Tsai-Chung Li
- Graduate Institute of Biostatistics, China Medical University, Taichung 40402, Taiwan
- Department of Healthcare Administration, College of Health Science, Asia University, Taichung 41354, Taiwan
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Hwang JP, Roundtree AK, Suarez-Almazor ME. Attitudes toward hepatitis B virus among Vietnamese, Chinese and Korean Americans in the Houston area, Texas. J Community Health 2013; 37:1091-100. [PMID: 22302653 DOI: 10.1007/s10900-012-9543-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
We explored attitudes about prevention, screening and treatment of hepatitis B virus (HBV) infection in Chinese, Korean and Vietnamese communities. We use qualitative methods in 12 focus groups (n = 113) of adults who self-reported their ethnicity to be Chinese, Korean, or Vietnamese. We use grounded theory (i.e., consensus-building between co-coders about recurring, emerging themes) for analysis. Diet, nutrition, fatigue and stress were misidentified as HBV causes. Improving hygiene, diet, exercise, and holistic methods were misidentified as viable HBV prevention methods. Common screening problems included not affording test and not understanding test results. Participants shared reasons for using complementary and alternative medicine--when Western medicine fails or becomes unaffordable. Participants sought information from medical providers and fellow community members, but also from the internet. Many of the attitudes and opinions that emerged may deter participation in HBV screening, prevention and treatment, insofar as community members may factor them into healthcare decision-making, choose alternative but ineffective methods of prevention and treatment, and undervalue the benefits of screening. More patient education in both traditional and new media is necessary for clarifying transmission, screening and treatment misunderstandings.
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Affiliation(s)
- Jessica P Hwang
- Department General Internal Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1465, Houston, TX 77030, USA.
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Upchurch DM, Wexler Rainisch BK. Racial and Ethnic Profiles of Complementary and Alternative Medicine Use Among Young Adults in the United States: Findings From the National Longitudinal Study of Adolescent Health. J Evid Based Complementary Altern Med 2012; 17:172-179. [PMID: 23869288 PMCID: PMC3711674 DOI: 10.1177/2156587212450713] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study describes complementary and alternative medicine use among a national sample of young adults, with an emphasis on characterizing racial and ethnic differences, highlighting variation across subgroups of Hispanics. The authors examined young adults ages 18 to 27 years (n = 14 128) from wave III (2001-2002) of the National Longitudinal Study of Adolescent Health. Prevalence estimates and logistic regression results were weighted and adjusted for complex sample design. The study examined recent complementary and alternative medicine use in the past 12 months, recent use for each of 15 specific complementary and alternative medicine modalities, and the 5 most commonly used modalities (herbs, massage, chiropractic, relaxation, and vitamins). Results showed that 29% of young adults aged 18 to 27 years recently used complementary and alternative medicine. Prevalence was highest among Cuban Americans (42%) and lowest among blacks (22%). Young adults used a diversity of complementary and alternative medicine modalities and there were substantial differences in use across racial and ethnic groups.
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Affiliation(s)
- Dawn M. Upchurch
- UCLA Fielding School of Public Health, University of California, Los Angeles, Los Angeles, CA, USA
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Liao YH, Lin CC, Li TC, Lin JG. Utilization pattern of traditional Chinese medicine for liver cancer patients in Taiwan. Altern Ther Health Med 2012; 12:146. [PMID: 22947144 PMCID: PMC3575295 DOI: 10.1186/1472-6882-12-146] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Accepted: 08/31/2012] [Indexed: 11/10/2022]
Abstract
Background Traditional Chinese Medicine (TCM) is one of the most popular complementary and alternative medicine modalities worldwide. In Chinese and East Asian societies, TCM plays an active role in the modern health care system and is even covered by the National Health Insurance Program of Taiwan. Liver cancer is the second most common cancer in Taiwan. This study aimed to analyze the TCM utilization patterns of patients with liver cancer from 1996–2007 using a population-based random sample of one million insured patients. Methods A cross-sectional study was conducted using registration and claim data sets from 1996 to 2007 obtained from the Longitudinal Health Insurance Database 2005 (LHID2005). The outpatient datasets contained the encounter form-based dates of visit, three items from the International Classification of Diseases (Ninth Revision, Clinical Modification codes), the primary procedure (e.g., drug or diagnostic procedure), type of copayment, billed amount, and paid amount. Only ambulatory care was analyzed. Results A total of 6358 liver cancer patients utilized ambulatory care during the study period. Among them, 1240 (19.50%) availed of TCM outpatient services. The prevalence of TCM use fluctuated during the study period, with a peak of 25.11% in 2001. After multivariable adjustment, the likelihood of TCM users was lower in participants aged 70 years and older (odds ratio, OR = 0.79, 95% confidence interval, CI: 0.64–0.97), males (OR = 0.60, 95% CI: 0.52–0.68), residents of Taipei (OR = 0.75, 95% CI: 0.58–0.96) as well as farmers and fishermen (OR = 0.71, 95% CI: 0.54–0.94), but was higher in residents of central Taiwan (OR = 1.99, 95% CI: 1.56–2.54. Most biomedicine and TCM outpatient services were provided by private clinics, followed by private hospitals. The two most frequently recorded coexisting diseases for both biomedicine and TCM outpatient visits specifically for liver cancer were (1) chronic liver disease and cirrhosis, and (2) malignant neoplasm of the liver and hepatic bile duct. The mean fee per visit for biomedicine was much higher than that for TCM, and the average expenditure was NT$429.73 (US$13.25) per biomedicine visit and NT$301.93 (US$9.32) per TCM visit (US$1 = NT$32.4 in 2007). For outpatient visits specifically for liver cancer, the mean fee per visit for biomedicine was much higher than that for TCM. The average cost per visit was NT$1457.31 (US$44.98) for biomedicine and NT$1080.76 (US$33.36) for TCM. Conclusion TCM was widely used by the patients with liver cancer, and the prevalence of TCM use remained stably high during the study period. The costs of insurance covering TCM were consistently lower than those covering biomedicine in patients with liver cancer. The findings of this study should be useful for health policy makers as well as researchers considering the integration of TCM and biomedicine.
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Concurrent use of antiplatelets, anticoagulants, or digoxin with Chinese medications: a population-based cohort study. Eur J Clin Pharmacol 2012; 69:629-39. [PMID: 22875040 DOI: 10.1007/s00228-012-1359-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2012] [Accepted: 07/12/2012] [Indexed: 10/28/2022]
Abstract
PURPOSE We examined the extent of concurrent use of antiplatelets, anticoagulants, or digoxin with Chinese medications (CMs) and identified its associated factors. METHODS A retrospective cohort study was conducted using one million random samples from the Longitudinal Health Insurance Database 2005 in Taiwan. High-risk Western medications (HRWMs) focused on in this study were antiplatelets (aspirin, clopidogrel, dipyridamole, ticlopidine), anticoagulants (heparin, warfarin), and digoxin. Concurrent use was described as having an overlapping use period of HRWM with CMs any time in 2005. Baseline demographics, comorbidities, and health service utilizations between patients with and without concurrent HRWM-CM use were compared. Logistic regression analyses were performed to identify factors associated with incident concurrent use. RESULTS Of the 70,698 eligible HRWM users, 13.2 % used CMs concurrently for an average duration of 26.7 ± 43 days. The incidence of concurrent HRWM-CM use, which excluded prior CM use within 6 months preceding the first CM use, was 6.3 %. Warfarin or ticlopidine users were more likely to be prescribed with CMs than were the other HRWM users. Factors associated with an increasing incidence of concurrent HRWM-CM use included female sex, age 45-54 years, middle monthly income, higher number of outpatient visits or distinct prescribed medications, and a previous diagnosis of heart diseases, stroke, or hypertension. In contrast, age ≥ 65 years and higher medical expenditure were associated with a lower incidence of concurrent use. CONCLUSIONS In the Taiwanese population, approximately one in eight HRWM users were concomitantly prescribed CMs. Whether such concurrent use is associated with adverse clinical outcomes warrants further investigations.
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Misra R, Balagopal P, Klatt M, Geraghty M. Complementary and Alternative Medicine Use Among Asian Indians in the United States: A National Study. J Altern Complement Med 2010; 16:843-52. [DOI: 10.1089/acm.2009.0517] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ranjita Misra
- Center for the Study of Health Disparities (CSHD), Department of Health and Kinesiology, Intercollegiate Faculty of Nutrition, Texas A&M University, College Station, TX
| | - Padmini Balagopal
- Home Science Department, Gandhigram Rural Institute, Tamilnadu, India
| | - Maryanna Klatt
- Department of Medical Dietetics, Health and Wellness, The Ohio State University, Columbus, OH
| | - Maureen Geraghty
- Department of Medical Dietetics, Health and Wellness, The Ohio State University, Columbus, OH
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Hastings-Tolsma M, Terada M. Complementary medicine use by nurse midwives in the U.S. Complement Ther Clin Pract 2009; 15:212-9. [DOI: 10.1016/j.ctcp.2009.06.016] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Ishaque S, Saleem T, Qidwai W. Knowledge, attitudes and practices regarding gemstone therapeutics in a selected adult population in Pakistan. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2009; 9:32. [PMID: 19709426 PMCID: PMC2739841 DOI: 10.1186/1472-6882-9-32] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2008] [Accepted: 08/26/2009] [Indexed: 12/03/2022]
Abstract
BACKGROUND Gemstones have been in use as part of alternative and complementary medicine for years. However, our understanding of the perceived healing powers of gemstones is limited. An extensive literature search revealed that there is a dearth of validated information on this subject. This study was therefore undertaken to explore the various aspects of the knowledge, attitudes, and practices of the public towards gemstone therapeutics. METHODS A survey was performed in the Community Health Centre of a tertiary care teaching hospital in Pakistan. Data collection was done via a face-to-face interview based on a structured, pre-tested questionnaire. Participants included all willing persons between 18-75 years of age approached prior to their appointments at the Community Health Centre. RESULTS The survey response rate was 86% (400/465). More than half (63%) of the study population was aware of the use of gemstone therapy. One hundred fifty-six individuals believed that gemstone use impacts health. Of this group, 39% believed that gemstone use increases physical strength. 62% believed that gemstone use is based on superstitious beliefs, whereas 28% opined that it is based on religious beliefs. 38% had used gemstones therapeutics formerly, while 24% were current users. Multiple logistic regression analysis revealed that age status and education status were significant (p < 0.05) independent predictors for both awareness of gemstone therapy and the belief that gemstone use impacts health. The elderly (aged 51-61) were 5.9-times more likely to believe that gemstones had an impact on health than the younger population (aged 18-28 years). (Adjusted Odd's Ratio = 5.9 [95% Confidence Interval = 2.9-11.9]). CONCLUSION More than half of our sample population is aware of the use of the gemstones for their various effects. Willingness to use gemstones is associated with the beliefs about the impact of gemstone therapy on health. Friends and family seem to be the major role players influencing people's willingness to use gemstones. CAM modalities should be recognized and considered as an important therapeutic option. We feel that gemstone therapy is a relatively unexplored area and more studies should, therefore, be conducted to gather more validated information on the subject.
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Affiliation(s)
- Sidra Ishaque
- Medical College, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan
| | - Taimur Saleem
- Medical College, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan
| | - Waris Qidwai
- Department of Family Medicine, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan
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Mehta DH, Gardiner PM, Phillips RS, McCarthy EP. Herbal and dietary supplement disclosure to health care providers by individuals with chronic conditions. J Altern Complement Med 2009; 14:1263-9. [PMID: 19032071 DOI: 10.1089/acm.2008.0290] [Citation(s) in RCA: 95] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Very little is known about herbal and dietary supplement disclosure in adults with chronic medical conditions, especially on a national level. OBJECTIVE To examine herbal and dietary supplement disclosure to conventional health care providers by adults with chronic medical conditions. DESIGN Data on herbal and dietary supplement use (N = 5456 users) in the previous year were used from the 2002 National Health Interview Survey. Bi-variable analyses compared characteristics between herbal and dietary supplement disclosers and nondisclosers. Multivariable logistic regression identified independent correlates of herbal and dietary supplement disclosure. RESULTS Overall, only 33% of herbal and dietary supplement users reported disclosing use of herbal and dietary supplements to their conventional health care provider. Among herbal and dietary supplement users with chronic conditions, less than 51% disclosed use to their conventional health care provider. Hispanic (adjusted odds ratio and 95% confidence interval = 0.70 [0.52, 0.94]) and Asian American (adjusted odds ratio and 95% confidence interval = 0.54 [0.33, 0.89]) adults were much less likely than non-Hispanic white Americans to disclose herbal and dietary supplement use. Having less than a high school education (adjusted odds ratio and 95% confidence interval = 0.61 [0.45, 0.82]) and not having insurance (adjusted odds ratio and 95% confidence interval = 0.77 [0.59, 1.00]) were associated with being less likely to disclose herbal and dietary supplement use. CONCLUSION Herbal and dietary supplement disclosure rates are low, even among adults with chronic conditions. These findings raise concerns about the safety of herbal and dietary supplements in combination with allopathic care. Future studies should focus on educating physicians about crosscultural care as well as eliciting information about herbal and dietary supplement use.
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Affiliation(s)
- Darshan H Mehta
- Benson-Henry Institute for Mind/Body Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA 02114, USA.
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Definitions and patterns of CAM use by the lay public. Complement Ther Med 2009; 17:71-7. [DOI: 10.1016/j.ctim.2008.09.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2007] [Revised: 09/11/2008] [Accepted: 09/11/2008] [Indexed: 01/28/2023] Open
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Disclosure of complementary and alternative medicine to conventional medical providers: variation by race/ethnicity and type of CAM. J Natl Med Assoc 2008; 100:1341-9. [PMID: 19024232 DOI: 10.1016/s0027-9684(15)31514-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Complementary and alternative medicine (CAM) is often used alongside conventional medical care, yet fewer than half of patients disclose CAM use to medical doctors. CAM disclosure is particularly low among racial/ethnic minorities, but reasons for differences, such as type of CAM used or quality of conventional healthcare, have not been explored. OBJECTIVE We tested the hypotheses that disclosure of CAM use to medical doctors is higher for provider-based CAM and among non-Hispanic whites, and that access to and quality of conventional medical care account for racial/ethnic differences in CAM disclosure. METHODS Bivariate and multiple variable analyses of the 2002 National Health Interview Survey and 2001 Health Care Quality Survey were performed. RESULTS Disclosure of CAM use to medical providers was higher for provider-based than self-care CAM. Disclosure of any CAM was associated with access to and quality of conventional care and higher among non-Latino whites relative to minorities. Having a regular doctor and quality patient-provider relationship mitigated racial/ethnic differences in CAM disclosure. CONCLUSION Insufficient disclosure of CAM use to conventional providers, particularly for self-care practices and among minority populations, represents a serious challenge in medical encounter communications. Efforts to improve disclosure of CAM use should be aimed at improving consistency of care and patient-physician communication across racial/ethnic groups.
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Ross LE, Hall IJ, Fairley TL, Taylor YJ, Howard DL. Prayer and self-reported health among cancer survivors in the United States, National Health Interview Survey, 2002. J Altern Complement Med 2008; 14:931-8. [PMID: 18925865 DOI: 10.1089/acm.2007.0788] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES At least 10.8 million living Americans have been diagnosed with cancer, and about 1.5 million new cancer cases are expected to be diagnosed in 2008. The purpose of this study was to examine prayer for health and self-reported health among a sample of men and women with a personal history of cancer. METHODS We used data from the 2002 National Health Interview Survey, which collected information on complementary and alternative medicine practices. RESULTS Among 2262 men and women with a history of cancer, 68.5% reported having prayed for their own health and 72% reported good or better health status. Among cancer survivors, praying for one's own health was associated with several sociodemographic variables including being female, non-Hispanic black, and married. Compared to persons with a history of skin cancer, persons with a history of breast cancer, colorectal cancer, a cancer with a short survival period (e.g., pancreatic cancer), or other cancers were more likely to pray for their health. Persons who reported good or better health were more likely to be female, younger, have higher levels of education and income, and have no history of additional chronic disease. Overall, praying for one's own health was inversely associated with good or better health status. CONCLUSIONS Data from this nationally representative sample indicate that prayer for health is commonly used among people with a history of cancer and that use of prayer varies by cancer site. The findings should add to the current body of literature that debates issues around spirituality, decision-making about treatment, and physician care.
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Affiliation(s)
- Louie E Ross
- Institute for Health, Social and Community Research, Shaw University, Raleigh, NC 27601, USA.
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Aziz Z, Tey NP. Herbal medicines: prevalence and predictors of use among Malaysian adults. Complement Ther Med 2008; 17:44-50. [PMID: 19114228 DOI: 10.1016/j.ctim.2008.04.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2007] [Revised: 01/29/2008] [Accepted: 04/14/2008] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE The aim of this study was to examine the prevalence and identify factors, which predict the use of herbal medicines among Malaysian adults. METHODS Using a cross-sectional design, data were collected via face-to-face interview using structured questionnaire from convenience sample of adults from four towns in Malaysia. Multivariate logistic regression analysis was used to identify the significant predictors of herbal medicines use. RESULTS From a total of 1601 respondents, 542 (33.9%) reported use of herbal medicines in the previous 12 months. Multivariate logistic regression analysis revealed the following variables to be predictive of herbal medicines use: female gender [odds ratio (OR) 1.80, confidence interval (CI) 1.40-2.31], being married [OR 1.97, CI 1.44-2.71], having health problems [OR 2.31, CI 1.74-3.07] and having high-income levels [OR 4.21, CI 1.72-10.30]. The odds of someone using herbal medicines also increases though slightly if someone has favorable opinions about herbal medicines on the aspects examined. On the other hand, being Chinese [OR 0.74, CI 0.57-0.96] and Indians [OR 0.17, CI 0.11-0.27] were associated with decreased odds of using herbal medicines compared to Malays. CONCLUSION The prevalence of herbal medicines use is high. Respondents' personal attributes and opinions influence their likelihood of using herbal medicines. These findings are important because knowledge of the predictors of herbal medicines use may help health care providers to identify patients at increased risk who would be candidates for receiving guidance on safe use of herbal medicines.
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Affiliation(s)
- Z Aziz
- Department of Pharmacy, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
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Su D, Li L, Pagán JA. Acculturation and the use of complementary and alternative medicine. Soc Sci Med 2007; 66:439-53. [PMID: 17923180 DOI: 10.1016/j.socscimed.2007.08.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2007] [Indexed: 11/15/2022]
Abstract
The use of complementary and alternative medicine (CAM) has been growing substantially in the US in recent years. Such a growth in CAM use coincides with an ongoing increase in the proportion of the foreign-born population in the US. The main objective of this study is to examine the relation between acculturation and the use of CAM therapies among immigrants. Data from a CAM supplement to the 2002 National Health Interview Survey were analyzed to estimate the effects of acculturation on the likelihood of using different CAM therapies over the past 12 months prior to the survey. The results suggest that the level of acculturation-as measured by nativity/length of stay in the US and language of interview-is strongly associated with CAM use. As immigrants stay longer in the US or as their use of English becomes more proficient, the likelihood that they use CAM therapies increases as well, and it gradually approaches the level of CAM use by native-born Americans. Moreover, this relation between acculturation and CAM use generally persists even after the effects of socioeconomic status, health insurance coverage, self-reported health status, and other demographic variables have all been taken into consideration. The substantially lower rates of CAM use by recent immigrants and its possible causes warrant further research.
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Affiliation(s)
- Dejun Su
- The University of Texas-Pan American, Edinburg, TX, USA.
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